Provider Demographics
NPI:1932645884
Name:GILMARTIN, EMMA LOVE (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:EMMA
Middle Name:LOVE
Last Name:GILMARTIN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MISS
Other - First Name:EMMA
Other - Middle Name:LOVE
Other - Last Name:GILMARTIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:11606 CHAPMAN HWY STE 2
Mailing Address - Street 2:
Mailing Address - City:SEYMOUR
Mailing Address - State:TN
Mailing Address - Zip Code:37865-5270
Mailing Address - Country:US
Mailing Address - Phone:865-579-7580
Mailing Address - Fax:
Practice Address - Street 1:11606 CHAPMAN HWY STE 2
Practice Address - Street 2:
Practice Address - City:SEYMOUR
Practice Address - State:TN
Practice Address - Zip Code:37865
Practice Address - Country:US
Practice Address - Phone:865-579-7580
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-17
Last Update Date:2019-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3653363A00000X, 363AM0700X
NMPA2017-0001363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant