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Individual
MRS. EMILY SUZANNE MATHEW
Active
Individual
MRS. EMILY SUZANNE MATHEW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP,RN, APN
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704240951
MI
363L00000X
Nurse Practitioner
745774
TX
363L00000X
Nurse Practitioner
AP122357
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
305234201
—
TX
05
—
305234202
—
TX
01
—
4704240951
STATE LICENSE
MI
01
—
885N91
BCBS
TX
01
—
P01879999
RAILROAD
TX
Enumeration date
05/22/2012
Last updated
03/17/2018
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