Provider Demographics
NPI:1932664273
Name:RITTER, EMMA MARIE (FNP-BC)
Entity Type:Individual
Prefix:
First Name:EMMA
Middle Name:MARIE
Last Name:RITTER
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 846098
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-6098
Mailing Address - Country:US
Mailing Address - Phone:903-324-6400
Mailing Address - Fax:
Practice Address - Street 1:815 S WASHINGTON AVE STE 100
Practice Address - Street 2:
Practice Address - City:MARSHALL
Practice Address - State:TX
Practice Address - Zip Code:75670-5316
Practice Address - Country:US
Practice Address - Phone:903-937-6800
Practice Address - Fax:903-935-0617
Is Sole Proprietor?:No
Enumeration Date:2019-01-31
Last Update Date:2019-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP139133363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX39623831Medicaid
TXP02220469OtherMEDICARE RAIL ROAD
TX774657OtherMEDICARE