Provider Demographics
NPI:1689370256
Name:ROMINE, EMMA (PA)
Entity Type:Individual
Prefix:
First Name:EMMA
Middle Name:
Last Name:ROMINE
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1120 POLARIS PKWY STE 200
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43240-4042
Mailing Address - Country:US
Mailing Address - Phone:614-880-9333
Mailing Address - Fax:614-880-9331
Practice Address - Street 1:1120 POLARIS PKWY STE 200
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43240-4042
Practice Address - Country:US
Practice Address - Phone:614-880-9333
Practice Address - Fax:614-880-9331
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-06
Last Update Date:2023-03-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH50.008013RX363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant