Provider Demographics
NPI:1437875747
Name:STUPP, EMMA ROSE (PA-C)
Entity Type:Individual
Prefix:
First Name:EMMA
Middle Name:ROSE
Last Name:STUPP
Suffix:
Gender:F
Credentials:PA-C
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Other - Credentials:
Mailing Address - Street 1:414 FRYSTOWN RD
Mailing Address - Street 2:
Mailing Address - City:MYERSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17067-1923
Mailing Address - Country:US
Mailing Address - Phone:717-639-6092
Mailing Address - Fax:
Practice Address - Street 1:33 W RIDGE PIKE STE 627
Practice Address - Street 2:
Practice Address - City:ROYERSFORD
Practice Address - State:PA
Practice Address - Zip Code:19468-1824
Practice Address - Country:US
Practice Address - Phone:610-226-6200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-18
Last Update Date:2022-10-18
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant