Provider Demographics
NPI:1932501467
Name:PROUSE, EMILY (RD, LD)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:PROUSE
Suffix:
Gender:F
Credentials:RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1512 W 6TH AVE STE B
Mailing Address - Street 2:
Mailing Address - City:EMPORIA
Mailing Address - State:KS
Mailing Address - Zip Code:66801-2400
Mailing Address - Country:US
Mailing Address - Phone:620-208-6577
Mailing Address - Fax:620-412-8954
Practice Address - Street 1:1512 W 6TH AVE STE B
Practice Address - Street 2:
Practice Address - City:EMPORIA
Practice Address - State:KS
Practice Address - Zip Code:66801-2400
Practice Address - Country:US
Practice Address - Phone:620-208-6577
Practice Address - Fax:620-412-8954
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-16
Last Update Date:2022-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1344133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered