Provider Demographics
NPI:1578556684
Name:EMERY, MARIE KERR (NP-C, FNP-BC)
Entity Type:Individual
Prefix:MS
First Name:MARIE
Middle Name:KERR
Last Name:EMERY
Suffix:
Gender:F
Credentials:NP-C, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:82 COLLEGE CIR
Mailing Address - Street 2:ROOM 102 HNS BUILDING
Mailing Address - City:DAHLONEGA
Mailing Address - State:GA
Mailing Address - Zip Code:30597-0001
Mailing Address - Country:US
Mailing Address - Phone:706-867-2713
Mailing Address - Fax:706-867-3249
Practice Address - Street 1:82 COLLEGE CIR
Practice Address - Street 2:ROOM 102, HNS BUILDING
Practice Address - City:DAHLONEGA
Practice Address - State:GA
Practice Address - Zip Code:30597-0001
Practice Address - Country:US
Practice Address - Phone:706-867-2713
Practice Address - Fax:706-867-3249
Is Sole Proprietor?:No
Enumeration Date:2005-08-24
Last Update Date:2009-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA64364363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000927638ABMedicaid
GAP41505Medicare UPIN