Individual
DR. MARY SUSAN EMERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN, PHD
Contact information
Practice address
2616 TUMBLE BROOK DR, LAS VEGAS, NV 89134-7869
(918) 606-0505
Mailing address
2616 TUMBLE BROOK DR, LAS VEGAS, NV 89134-7869
(918) 606-0505
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
063436
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
425324506
—
MO
Enumeration date
07/15/2005
Last updated
02/17/2015
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