Provider Demographics
NPI:1760806707
Name:COUNTY OF EMMET
Entity Type:Organization
Organization Name:COUNTY OF EMMET
Other - Org Name:EMMET COUNTY PUBLIC HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:NURSE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:R
Authorized Official - Last Name:PRESTON
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:712-362-2490
Mailing Address - Street 1:508 S 1ST ST
Mailing Address - Street 2:
Mailing Address - City:ESTHERVILLE
Mailing Address - State:IA
Mailing Address - Zip Code:51334-2521
Mailing Address - Country:US
Mailing Address - Phone:712-362-2490
Mailing Address - Fax:712-362-7160
Practice Address - Street 1:508 S 1ST ST
Practice Address - Street 2:
Practice Address - City:ESTHERVILLE
Practice Address - State:IA
Practice Address - Zip Code:51334-2521
Practice Address - Country:US
Practice Address - Phone:712-362-2490
Practice Address - Fax:712-362-7160
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-11
Last Update Date:2014-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0670844Medicaid
16-7084Medicare PIN