Provider Demographics
NPI:1598914491
Name:ATKINS, EMILY A (PA)
Entity Type:Individual
Prefix:MS
First Name:EMILY
Middle Name:A
Last Name:ATKINS
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:A
Other - Last Name:ATKINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1111 S EUCLID AVE
Mailing Address - Street 2:
Mailing Address - City:BAY CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48706-3309
Mailing Address - Country:US
Mailing Address - Phone:989-439-1235
Mailing Address - Fax:989-439-1238
Practice Address - Street 1:1111 S EUCLID AVE
Practice Address - Street 2:
Practice Address - City:BAY CITY
Practice Address - State:MI
Practice Address - Zip Code:48706-3309
Practice Address - Country:US
Practice Address - Phone:989-439-1235
Practice Address - Fax:989-439-1238
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-16
Last Update Date:2020-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5601005429363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Single Specialty