Provider Demographics
NPI:1891479622
Name:EMMONS, EMILY ANN (APRN)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:ANN
Last Name:EMMONS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:436 FORT PICKENS RD
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32561-2014
Mailing Address - Country:US
Mailing Address - Phone:850-602-6040
Mailing Address - Fax:
Practice Address - Street 1:436 FORT PICKENS RD
Practice Address - Street 2:
Practice Address - City:PENSACOLA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32561-2014
Practice Address - Country:US
Practice Address - Phone:850-602-6040
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-12
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11026383363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner