Provider Demographics
NPI:1962852723
Name:MESSMER, EMILY J (FNP)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:J
Last Name:MESSMER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:
Other - Last Name:ST. CLAIR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:1501 NE MEDICAL CENTER DR
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97701-6099
Mailing Address - Country:US
Mailing Address - Phone:541-382-2811
Mailing Address - Fax:
Practice Address - Street 1:7950 KIPLING ST STE 101
Practice Address - Street 2:
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80005-3925
Practice Address - Country:US
Practice Address - Phone:303-425-4680
Practice Address - Fax:303-425-1616
Is Sole Proprietor?:No
Enumeration Date:2016-06-13
Last Update Date:2018-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0992366-NP363LF0000X
OR201806836NP-PP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR201806836NP-PPOtherLICENSE