Individual
EMILY JANE LIGHT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5545 N WICKHAM RD STE 110, MELBOURNE, FL 32940-7323
(321) 779-9838
Mailing address
887 GAZEBO CIR APT 6208, MELBOURNE, FL 32904-5240
(321) 313-0267
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN9609842
FL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
11039936
FL
Other
Enumeration date
11/06/2024
Last updated
06/04/2025
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