Individual
MRS. EMILY ELIZABETH MAYTUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
280 CENTRAL AVE, LOGRASSO HALL STUDENT HEALTH CENTER, FREDONIA, NY 14063-1127
(716) 673-3131
(716) 673-4722
Mailing address
280 CENTRAL AVE, LOGRASSO HALL STUDENT HEALTH CENTER, FREDONIA, NY 14063-1127
(716) 673-3131
(716) 673-4722
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
F337466
NY
Other
Enumeration date
09/25/2012
Last updated
11/17/2015
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