Provider Demographics
NPI:1659053817
Name:BORGUS, EMILY (AGPCNP)
Entity type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:
Last Name:BORGUS
Suffix:
Gender:
Credentials:AGPCNP
Other - Prefix:MISS
Other - First Name:EMILY
Other - Middle Name:
Other - Last Name:SLAGTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:240 EAST JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:NORTH LIBERTY
Mailing Address - State:IA
Mailing Address - Zip Code:52317-9092
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1085 LIBERTY WAY
Practice Address - Street 2:SUITE 119
Practice Address - City:NORTH LIBERTY
Practice Address - State:IA
Practice Address - Zip Code:52317
Practice Address - Country:US
Practice Address - Phone:123-123-1234
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-07
Last Update Date:2025-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY311450363LA2200X
IAH182740363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health