Provider Demographics
NPI:1952942161
Name:HARRELL, EMILY J (PHYSICIAN ASSISTANT)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:J
Last Name:HARRELL
Suffix:
Gender:F
Credentials:PHYSICIAN ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1110 AIRPORT BLVD
Mailing Address - Street 2:STE B
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32504-8649
Mailing Address - Country:US
Mailing Address - Phone:850-438-1136
Mailing Address - Fax:850-438-1148
Practice Address - Street 1:1110 AIRPORT BLVD
Practice Address - Street 2:STE B
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32504-8649
Practice Address - Country:US
Practice Address - Phone:850-438-1136
Practice Address - Fax:850-438-1148
Is Sole Proprietor?:No
Enumeration Date:2019-09-30
Last Update Date:2022-07-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLPA9112476363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant