Provider Demographics
NPI:1750099479
Name:KLEINSCHRODT, EMILY TOWLE (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:TOWLE
Last Name:KLEINSCHRODT
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:JAYNE BRONWEN
Other - Last Name:TOWLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1221 W LAKEVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32501-1836
Mailing Address - Country:US
Mailing Address - Phone:850-469-3500
Mailing Address - Fax:850-595-1400
Practice Address - Street 1:1221 W LAKEVIEW AVE
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32501-1836
Practice Address - Country:US
Practice Address - Phone:850-432-1222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-10
Last Update Date:2024-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-183589163W00000X
FL11035355363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse