Provider Demographics
NPI:1376081315
Name:DAY, EMERALD
Entity Type:Individual
Prefix:
First Name:EMERALD
Middle Name:
Last Name:DAY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3329 MEMPHIS ST
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39213-5664
Mailing Address - Country:US
Mailing Address - Phone:601-573-6925
Mailing Address - Fax:
Practice Address - Street 1:3329 MEMPHIS ST
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39213-5664
Practice Address - Country:US
Practice Address - Phone:601-573-6925
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-10
Last Update Date:2017-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide