Provider Demographics
NPI:1568941912
Name:EMERY, GEORGETTE ELAINE (RN)
Entity Type:Individual
Prefix:
First Name:GEORGETTE
Middle Name:ELAINE
Last Name:EMERY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:375 SANDALWOOD LN
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78216-6842
Mailing Address - Country:US
Mailing Address - Phone:210-254-4382
Mailing Address - Fax:210-994-6978
Practice Address - Street 1:5726 W HAUSMAN RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78249-1650
Practice Address - Country:US
Practice Address - Phone:210-349-7030
Practice Address - Fax:210-349-0097
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-07
Last Update Date:2018-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX934005163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health