Provider Demographics
NPI:1366462798
Name:EMKE, PAMELA (RN,CS,MSN,FNP)
Entity Type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:
Last Name:EMKE
Suffix:
Gender:F
Credentials:RN,CS,MSN,FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:686 LESTER ST
Mailing Address - Street 2:
Mailing Address - City:POPLAR BLUFF
Mailing Address - State:MO
Mailing Address - Zip Code:63901-5025
Mailing Address - Country:US
Mailing Address - Phone:557-368-6241
Mailing Address - Fax:573-686-8452
Practice Address - Street 1:686 LESTER ST
Practice Address - Street 2:
Practice Address - City:POPLAR BLUFF
Practice Address - State:MO
Practice Address - Zip Code:63901-5025
Practice Address - Country:US
Practice Address - Phone:557-368-6241
Practice Address - Fax:573-686-8452
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2008-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO086493363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner