Provider Demographics
NPI:1760256317
Name:CUSHING, EMILY MARIE (RPH)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:MARIE
Last Name:CUSHING
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4208 W 62ND TER
Mailing Address - Street 2:
Mailing Address - City:FAIRWAY
Mailing Address - State:KS
Mailing Address - Zip Code:66205-3216
Mailing Address - Country:US
Mailing Address - Phone:816-786-6836
Mailing Address - Fax:
Practice Address - Street 1:4300 RAINBOW BLVD
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66103-3425
Practice Address - Country:US
Practice Address - Phone:913-403-0581
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-14
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1-111380183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist