Provider Demographics
NPI:1932479771
Name:NURNBERG, EMILY GAYLE (OTR, CLT)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:GAYLE
Last Name:NURNBERG
Suffix:
Gender:F
Credentials:OTR, CLT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1515 N PINE GROVE ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67212-6958
Mailing Address - Country:US
Mailing Address - Phone:316-644-7919
Mailing Address - Fax:833-939-3552
Practice Address - Street 1:415 N LANCASTER CT
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67230-7808
Practice Address - Country:US
Practice Address - Phone:316-644-7919
Practice Address - Fax:833-939-3552
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-11
Last Update Date:2021-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist