Provider Demographics
NPI:1477885648
Name:VASILCHEK, EMILY RAE (CPNP)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:RAE
Last Name:VASILCHEK
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 JAVIT CT
Mailing Address - Street 2:
Mailing Address - City:AUSTINTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44515-2442
Mailing Address - Country:US
Mailing Address - Phone:330-797-0407
Mailing Address - Fax:
Practice Address - Street 1:107 JAVIT CT
Practice Address - Street 2:
Practice Address - City:AUSTINTOWN
Practice Address - State:OH
Practice Address - Zip Code:44515-2442
Practice Address - Country:US
Practice Address - Phone:330-797-0407
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-12
Last Update Date:2018-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA. 11340-NP363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics