Provider Demographics
NPI:1942607262
Name:EMERY, RACHEL ELIZABETH (MSN, RN, FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:ELIZABETH
Last Name:EMERY
Suffix:
Gender:F
Credentials:MSN, RN, FNP-BC
Other - Prefix:MISS
Other - First Name:RACHEL
Other - Middle Name:ELIZABETH
Other - Last Name:BURKHOLDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:3400 E MARKET ST
Mailing Address - Street 2:
Mailing Address - City:LOGANSPORT
Mailing Address - State:IN
Mailing Address - Zip Code:46947-2295
Mailing Address - Country:US
Mailing Address - Phone:574-722-9633
Mailing Address - Fax:
Practice Address - Street 1:3400 E MARKET ST
Practice Address - Street 2:
Practice Address - City:LOGANSPORT
Practice Address - State:IN
Practice Address - Zip Code:46947-2295
Practice Address - Country:US
Practice Address - Phone:574-722-9633
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-02
Last Update Date:2017-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28190705A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201268660Medicaid
IN000000913716OtherANTHEM
INP01412641OtherRAILROAD MEDICARE
IN940670028Medicare PIN