1750461356 NPI number — MS. MICHELE KATHRYN EMMETT L.C.P.C./ L.P.C.

Table of content: MS. MICHELE KATHRYN EMMETT L.C.P.C./ L.P.C. (NPI 1750461356)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1750461356 NPI number — MS. MICHELE KATHRYN EMMETT L.C.P.C./ L.P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
EMMETT
Provider First Name:
MICHELE
Provider Middle Name:
KATHRYN
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
L.C.P.C./ L.P.C.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1750461356
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
329 E GRANT ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GREENCASTLE
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
17225-1015
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
717-597-5037
Provider Business Mailing Address Fax Number:
301-790-9674

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
580 NORTHERN AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HAGERSTOWN
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21742-2847
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-791-9760
Provider Business Practice Location Address Fax Number:
301-791-9674
Provider Enumeration Date:
10/17/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YP2500X , with the licence number:  LCO 656 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 101YP2500X , with the licence number: PC000956 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)





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