Provider Demographics
NPI:1831609866
Name:VERSEMAN, EMILY KATHLEEN (FNP)
Entity type:Individual
Prefix:MISS
First Name:EMILY
Middle Name:KATHLEEN
Last Name:VERSEMAN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2866 S 750 E
Mailing Address - Street 2:
Mailing Address - City:WALDRON
Mailing Address - State:IN
Mailing Address - Zip Code:46182-9710
Mailing Address - Country:US
Mailing Address - Phone:317-374-8262
Mailing Address - Fax:
Practice Address - Street 1:212 E 10TH ST
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:IN
Practice Address - Zip Code:47240-8249
Practice Address - Country:US
Practice Address - Phone:812-222-0970
Practice Address - Fax:812-222-0972
Is Sole Proprietor?:No
Enumeration Date:2017-10-04
Last Update Date:2017-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28178448A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily