Provider Demographics
NPI:1467929679
Name:DENISCO, EMILY CAROLINE (APRN,FNP-C)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:CAROLINE
Last Name:DENISCO
Suffix:
Gender:F
Credentials:APRN,FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17523 N DALE MABRY HWY
Mailing Address - Street 2:
Mailing Address - City:LUTZ
Mailing Address - State:FL
Mailing Address - Zip Code:33548-4521
Mailing Address - Country:US
Mailing Address - Phone:813-774-5733
Mailing Address - Fax:813-774-5619
Practice Address - Street 1:17523 N DALE MABRY HWY
Practice Address - Street 2:
Practice Address - City:LUTZ
Practice Address - State:FL
Practice Address - Zip Code:33548-4521
Practice Address - Country:US
Practice Address - Phone:813-774-5733
Practice Address - Fax:813-774-5619
Is Sole Proprietor?:No
Enumeration Date:2018-10-25
Last Update Date:2018-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9389078363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily