Provider Demographics
NPI:1841764115
Name:EMERSON, HANNAH NICOLE (MS, ATC, NR-EMT)
Entity Type:Individual
Prefix:MS
First Name:HANNAH
Middle Name:NICOLE
Last Name:EMERSON
Suffix:
Gender:F
Credentials:MS, ATC, NR-EMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 HEDGEROW DR APT 5
Mailing Address - Street 2:
Mailing Address - City:ORCHARD PARK
Mailing Address - State:NY
Mailing Address - Zip Code:14127-4430
Mailing Address - Country:US
Mailing Address - Phone:248-408-8548
Mailing Address - Fax:
Practice Address - Street 1:4865 GREENVIEW DR
Practice Address - Street 2:
Practice Address - City:COMMERCE TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48382-1566
Practice Address - Country:US
Practice Address - Phone:248-408-8548
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-18
Last Update Date:2020-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer