Provider Demographics
NPI:1265122642
Name:EMERY, ERIKA (CCMA, CRMA)
Entity type:Individual
Prefix:
First Name:ERIKA
Middle Name:
Last Name:EMERY
Suffix:
Gender:F
Credentials:CCMA, CRMA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2472 ROUTE 2
Mailing Address - Street 2:
Mailing Address - City:HERMON
Mailing Address - State:ME
Mailing Address - Zip Code:04401-0624
Mailing Address - Country:US
Mailing Address - Phone:207-356-6851
Mailing Address - Fax:207-605-0144
Practice Address - Street 1:2472 ROUTE 2
Practice Address - Street 2:
Practice Address - City:HERMON
Practice Address - State:ME
Practice Address - Zip Code:04401-0624
Practice Address - Country:US
Practice Address - Phone:207-356-6851
Practice Address - Fax:207-605-0144
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-10
Last Update Date:2023-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MERCC39036253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care