Provider Demographics
NPI:1952109217
Name:EMMERT, CHELSEA (NP)
Entity type:Individual
Prefix:
First Name:CHELSEA
Middle Name:
Last Name:EMMERT
Suffix:
Gender:
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 E STATE HIGHWAY 243 STE 121
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:TX
Mailing Address - Zip Code:75103-2418
Mailing Address - Country:US
Mailing Address - Phone:903-567-4692
Mailing Address - Fax:
Practice Address - Street 1:301 E STATE HIGHWAY 243 STE 121
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:TX
Practice Address - Zip Code:75103-2418
Practice Address - Country:US
Practice Address - Phone:903-567-4692
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-04
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1191291363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner