Provider Demographics
NPI:1598021610
Name:MARKHAM, EMILY ROSE (LPN)
Entity Type:Individual
Prefix:MISS
First Name:EMILY
Middle Name:ROSE
Last Name:MARKHAM
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6107 RIDGE CHAPEL RD
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSON
Mailing Address - State:NY
Mailing Address - Zip Code:14589-9351
Mailing Address - Country:US
Mailing Address - Phone:315-690-1595
Mailing Address - Fax:
Practice Address - Street 1:6107 RIDGE CHAPEL RD
Practice Address - Street 2:
Practice Address - City:WILLIAMSON
Practice Address - State:NY
Practice Address - Zip Code:14589-9351
Practice Address - Country:US
Practice Address - Phone:315-690-1595
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-03
Last Update Date:2012-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY308391-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse