Individual
EMMA WASKOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
2326 18TH ST STE 230, COLUMBUS, IN 47201-5359
(812) 376-9261
Mailing address
PO BOX 775383, CHICAGO, IL 60677-5383
(812) 376-5315
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10004864A
IN
363AM0700X
Medical Physician Assistant
PA-1320
AR
Other
Enumeration date
10/10/2024
Last updated
08/15/2025
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