Provider Demographics
NPI:1972377059
Name:WIMSATT, EMILY ANNE (RN)
Entity Type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:ANNE
Last Name:WIMSATT
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MISS
Other - First Name:EMILY
Other - Middle Name:ANNE
Other - Last Name:SCHOCK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1563 CEDAR AVE
Mailing Address - Street 2:
Mailing Address - City:SHERIDAN
Mailing Address - State:WY
Mailing Address - Zip Code:82801-5434
Mailing Address - Country:US
Mailing Address - Phone:605-377-7327
Mailing Address - Fax:
Practice Address - Street 1:1563 CEDAR AVE
Practice Address - Street 2:
Practice Address - City:SHERIDAN
Practice Address - State:WY
Practice Address - Zip Code:82801-5434
Practice Address - Country:US
Practice Address - Phone:605-377-7327
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-09
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY51124163WC0200X, 163WE0003X, 163WX0003X, 163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine
No163WE0003XNursing Service ProvidersRegistered NurseEmergency
No163WX0003XNursing Service ProvidersRegistered NurseObstetric, Inpatient