Provider Demographics
NPI:1508432899
Name:PASKEWITZ, EMILY YOUNG (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:YOUNG
Last Name:PASKEWITZ
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:772 SHELBY LYNN DR
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:TN
Mailing Address - Zip Code:37172-4573
Mailing Address - Country:US
Mailing Address - Phone:931-200-1746
Mailing Address - Fax:
Practice Address - Street 1:586 S JEFFERSON AVE STE P
Practice Address - Street 2:
Practice Address - City:COOKEVILLE
Practice Address - State:TN
Practice Address - Zip Code:38501-4632
Practice Address - Country:US
Practice Address - Phone:931-854-0050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-27
Last Update Date:2021-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN29335363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care