Provider Demographics
NPI:1740241462
Name:SARD, EMILY J (NP)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:J
Last Name:SARD
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5402 S STAPLES ST STE 103
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78411-4656
Mailing Address - Country:US
Mailing Address - Phone:361-980-1299
Mailing Address - Fax:361-986-8988
Practice Address - Street 1:5402 S STAPLES ST STE 103
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78411-4656
Practice Address - Country:US
Practice Address - Phone:361-980-1299
Practice Address - Fax:361-986-8988
Is Sole Proprietor?:No
Enumeration Date:2006-03-31
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY334150363LW0102X
TX845847363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY040426004034OtherFIDELIS CARE
NY00026496501OtherUNIVERA
NY000560810001OtherBC/BS OF WNY
NY02426373Medicaid
NY00026496501OtherUNIVERA
NY000560810001OtherBC/BS OF WNY