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Individual

MRS. SUSAN L EMMERICH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ARNP, CPNP

Contact information

Practice address
1215 DUNN AVE, JACKSONVILLE, FL 32218-6330
(904) 757-1998
(904) 696-7462
Mailing address
1215 DUNN AVE, JACKSONVILLE, FL 32218-6330
(904) 757-1998
(904) 696-7462

Taxonomy

Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
ARNP9380555
FL
363LP0200X
Pediatric Nurse Practitioner
C056595
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
5200629
STATE PHARMACY LISCENSE
IA
01
ARNP9380555
FL STATE LICENSE
FL
01
C 056595
IA NURSE LISCENSE
IA
Enumeration date
04/09/2007
Last updated
03/07/2023
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