Provider Demographics
NPI:1679441547
Name:STREETER, EMILY ANN (MSN, APRN, CNM)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:ANN
Last Name:STREETER
Suffix:
Gender:F
Credentials:MSN, APRN, CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:755 N 11TH ST STE 4200
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77702-1500
Mailing Address - Country:US
Mailing Address - Phone:409-899-1499
Mailing Address - Fax:
Practice Address - Street 1:755 N 11TH ST STE 4200
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77702-1500
Practice Address - Country:US
Practice Address - Phone:409-899-1499
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-23
Last Update Date:2025-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1216205367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife