Provider Demographics
NPI:1437890449
Name:DEISS, EMILY (CNP)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:DEISS
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11735 FM 773
Mailing Address - Street 2:
Mailing Address - City:BEN WHEELER
Mailing Address - State:TX
Mailing Address - Zip Code:75754-6400
Mailing Address - Country:US
Mailing Address - Phone:715-781-5358
Mailing Address - Fax:
Practice Address - Street 1:11735 FM 773
Practice Address - Street 2:
Practice Address - City:BEN WHEELER
Practice Address - State:TX
Practice Address - Zip Code:75754-6400
Practice Address - Country:US
Practice Address - Phone:715-781-5358
Practice Address - Fax:715-781-5358
Is Sole Proprietor?:No
Enumeration Date:2022-04-05
Last Update Date:2025-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXCS00231124363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily