Provider Demographics
NPI:1831564988
Name:ATCHER, EMILY ANN (PA-C)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:ANN
Last Name:ATCHER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:ANNN
Other - Last Name:GOEDDE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:615 S PRESTON ST
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40202-1715
Mailing Address - Country:US
Mailing Address - Phone:502-852-0255
Mailing Address - Fax:502-852-4039
Practice Address - Street 1:615 S PRESTON ST
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202-1715
Practice Address - Country:US
Practice Address - Phone:502-852-0255
Practice Address - Fax:502-852-4039
Is Sole Proprietor?:No
Enumeration Date:2015-12-01
Last Update Date:2018-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN300010519Medicaid
KY7100399720Medicaid