Provider Demographics
NPI:1811025059
Name:WILFORD, EMILY G (CRNP)
Entity type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:G
Last Name:WILFORD
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2116 9TH ST
Mailing Address - Street 2:
Mailing Address - City:CUYAHOGA FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44221-3125
Mailing Address - Country:US
Mailing Address - Phone:330-926-9026
Mailing Address - Fax:
Practice Address - Street 1:2663 CLEVELAND AVE NW
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44709-3393
Practice Address - Country:US
Practice Address - Phone:330-456-5329
Practice Address - Fax:330-456-9679
Is Sole Proprietor?:No
Enumeration Date:2007-03-01
Last Update Date:2024-08-26
Deactivation Date:2022-02-15
Deactivation Code:
Reactivation Date:2024-08-26
Provider Licenses
StateLicense IDTaxonomies
OHNP-07849363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3015954Medicaid
OHNP30472Medicare PIN