Provider Demographics
NPI:1659064137
Name:SNOWAERT, EMILY ROSE (PA-C)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:ROSE
Last Name:SNOWAERT
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:ROSE
Other - Last Name:BARRIE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8119 CALKINS RD
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48532-5526
Mailing Address - Country:US
Mailing Address - Phone:810-620-6284
Mailing Address - Fax:
Practice Address - Street 1:2429 TRAUTNER DR
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48604-9596
Practice Address - Country:US
Practice Address - Phone:989-583-5514
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-31
Last Update Date:2024-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant