# MRS. EMILY SUZANNE MATHEW

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1205196458
- **Gender:** F
- **Credential:** NP,RN, APN

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | 4704240951 | MI | Yes |
| 363L00000X | Nurse Practitioner | 745774 | TX | — |
| 363L00000X | Nurse Practitioner | AP122357 | TX | — |

## Other

- **Enumeration date:** 05/22/2012
- **Last updated:** 03/17/2018

## 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 |