Individual
JENNIFER M EMMERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
3750 LANDMARK DR STE A, LAFAYETTE, IN 47905-6652
(765) 807-2780
(765) 807-2781
Mailing address
29943 NETWORK PL, CHICAGO, IL 60673-1299
(317) 706-7246
(317) 706-3419
Taxonomy
Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
Primary
71001915A
IN
363LA2100X
Acute Care Nurse Practitioner
71001915A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201010640
—
IN
Enumeration date
05/16/2006
Last updated
12/03/2024
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