Provider Demographics
NPI:1457706327
Name:EMMERICH, MARIE LYN (APRN)
Entity Type:Individual
Prefix:
First Name:MARIE
Middle Name:LYN
Last Name:EMMERICH
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:MARIE
Other - Middle Name:LYN
Other - Last Name:GREER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:704 W NYE LN
Mailing Address - Street 2:STE 102
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89703-1569
Mailing Address - Country:US
Mailing Address - Phone:775-885-8890
Mailing Address - Fax:
Practice Address - Street 1:975 RYLAND ST STE 100
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-1669
Practice Address - Country:US
Practice Address - Phone:775-982-5000
Practice Address - Fax:775-982-5225
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-28
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVRN90514163W00000X
NV823098363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV823098OtherNEVADA STATE BOARD OF NURSING