Provider Demographics
NPI:1457197345
Name:SKY, EMMA (IMD)
Entity type:Individual
Prefix:DR
First Name:EMMA
Middle Name:
Last Name:SKY
Suffix:
Gender:F
Credentials:IMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2064 W WINNIE LN
Mailing Address - Street 2:
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89703-7411
Mailing Address - Country:US
Mailing Address - Phone:775-233-8844
Mailing Address - Fax:
Practice Address - Street 1:2064 W WINNIE LN
Practice Address - Street 2:
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89703-7411
Practice Address - Country:US
Practice Address - Phone:775-233-8844
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-01
Last Update Date:2024-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV34574306171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach