Provider Demographics
NPI:1972231710
Name:BLEECH, EMILY JANELLE (RN)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:JANELLE
Last Name:BLEECH
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4016 SLEIGHT RD
Mailing Address - Street 2:
Mailing Address - City:BATH
Mailing Address - State:MI
Mailing Address - Zip Code:48808-9407
Mailing Address - Country:US
Mailing Address - Phone:517-648-7869
Mailing Address - Fax:
Practice Address - Street 1:4016 SLEIGHT RD
Practice Address - Street 2:
Practice Address - City:BATH
Practice Address - State:MI
Practice Address - Zip Code:48808-9407
Practice Address - Country:US
Practice Address - Phone:517-648-7869
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-10
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704318838163W00000X, 367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse