Emerson, Mary Susan

Emerson, Mary Susan is an sole proprietor health care provider with primary practice located at 2616 Tumble Brook Dr , Las Vegas NV 89134-7869. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Adult Health, which is considered as her primary health care specialty. Emerson, Mary Susan can be contacted via phone (918) 606-0505.

Contact Information

Primary practice address
2616 Tumble Brook Dr Las Vegas NV 89134-7869
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X 063436 Missouri

Profile Details

NPI number 1790784452
LBN Legal business name Emerson, Mary Susan
Credentials APRN, PHD
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 15th, 2005
Last updated Feb 17th, 2015 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1790784452 NPPES
Missouri MEDICAID 425324506

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