Provider Demographics
NPI:1548413636
Name:NAYAR, EMILY E (PA-C)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:E
Last Name:NAYAR
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:704 S 8TH ST
Mailing Address - Street 2:P.O. BOX 530
Mailing Address - City:MCLOUD
Mailing Address - State:OK
Mailing Address - Zip Code:74851-8633
Mailing Address - Country:US
Mailing Address - Phone:405-964-6463
Mailing Address - Fax:405-964-2412
Practice Address - Street 1:704 S 8TH ST
Practice Address - Street 2:
Practice Address - City:MCLOUD
Practice Address - State:OK
Practice Address - Zip Code:74851-8633
Practice Address - Country:US
Practice Address - Phone:405-964-6463
Practice Address - Fax:405-964-2412
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-03
Last Update Date:2008-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKPA1769363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical