MRS. SUSAN L EMMERICH (NPI# 1700909389) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700909389 |
| Entity Type | Individual |
| Full Name | MRS. SUSAN L EMMERICH |
| Credential | ARNP, CPNP |
| Practice Address |
1215 Dunn Ave Jacksonville FL 32218-6330 |
| Practice Telephone | 9047571998 |
| Practice Fax Number | 9046967462 |
| Mailing Telephone | 9047571998 |
| Mailing Fax Number | 9046967462 |
| Enumeration Date | 2007-04-09 |
| Last Update Date | 2014-06-26 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
ARNP9380555 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
C056595 | IA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IA | IA NURSE LISCENSE | C 056595 | 01 |
| IA | DEA NUMBER | ME0928296 | 01 |
| IA | STATE PHARMACY LISCENSE | 5200629 | 01 |
| FL | FL STATE LICENSE | ARNP9380555 | 01 |
| Street Address |
1215 DUNN AVE |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32218-6330 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417922469 | Anthony Vaz | Specialist | 1215 Dunn Ave, Jacksonville, FL 32218-6330 | 2006-02-22 |
| 1255996625 | Renee Christine Aulisi | Registered Nurse | 1215 Dunn Ave, Jacksonville, FL 32218-6330 | 2019-05-01 |
| 1417435884 | Tameerah Mebane | Nurse Practitioner | 1215 Dunn Ave, Jacksonville, FL 32218-6330 | 2018-07-29 |
| 1629561451 | Otis Green IIi | Nurse Practitioner | 1215 Dunn Ave, Jacksonville, FL 32218-6330 | 2018-06-06 |
| 1174042212 | King David Mungin Sr. | Nurse Practitioner | 1215 Dunn Ave, Jacksonville, FL 32218-6330 | 2017-09-10 |
| 1811367618 | Heather Ledford | Nurse Practitioner | 1215 Dunn Ave, Suite 1, Jacksonville, FL 32218-6330 | 2015-10-06 |
| 1023424694 | Total Renal Care, Inc | Clinic/Center | 1215 Dunn Ave, Ste 8, Jacksonville, FL 32218-4897 | 2014-07-03 |
| 1962820738 | Victoria Godwin Udongwo | Nurse Practitioner | 1215 Dunn Ave, Jacksonville, FL 32218-6330 | 2014-03-31 |
| 1801138391 | Denise Marie Ward | Nurse Practitioner | 1215 Dunn Ave, Suite1, Jacksonville, FL 32218-6330 | 2013-03-22 |
| 1093061723 | Gerardo Augusto Montanez Galvis | Nurse Practitioner | 1215 Dunn Ave, Suite 1, Jacksonville, FL 32218-6330 | 2012-07-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629684170 | Damon Lamar Baker | Nurse Practitioner | 12533 Sampson Rd, Jacksonville, Fl, FL 32218 | 2020-09-21 |
| 1578199303 | First Coast Health Ventures, LLC | Skilled Nursing Facility | 15480 Max Leggett Parkway, Jacksonville, FL 32218 | 2020-03-12 |
| 1932679594 | Alaina Rachelle Stanley | Counselor | 11683 Spring Board Dr, Jacksonville, FL 32218 | 2018-11-27 |
| 1508345133 | War Cry Ministry Inc | Counselor | 435 Eric Ave, Jacksonville, FL 32218 | 2018-08-14 |
| 1285111484 | St Vincent's Full Service Urgent Care, LLC | Clinic/Center | 15510 Max Leggett Parkway, Ste A, Jacksonville, FL 32218 | 2018-07-20 |
| 1427544501 | Derrick Roberts | Behavioral Analyst | 11302 Forestdale Rd, Jacksonville, FL 32218 | 2018-07-02 |
| 1215420229 | Companion & Compassion LLC | Home Health | 856 Poydras Ln W, Jacksonville, FL 32218 | 2018-06-13 |
| 1952894784 | Michael Alexander Aaro | Dentist | 1840 Dunn Ave Ste 3, Jacksonville, FL 32218 | 2018-06-06 |
| 1235629445 | Melissa C Moree | Counselor | 13453 Main St. North, Suite 104, Jacksonville, FL 32218 | 2018-05-14 |
| 1861900896 | Sheila Nowlin | Physical Therapist | 1034 Dunn Ave, Jacksonville, FL 32218 | 2018-01-11 |
| Find all providers in zip 32218 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144707183 | Kevin Troup | Nurse Practitioner | 559 Apple Creek Dr, Jacksonville, FL 32218-8954 | 2018-07-23 |
| 1629447552 | Kelly Conway Watson | Nurse Practitioner | 12317 Soaring Flight Dr, Jacksonville, FL 32225-0784 | 2015-09-22 |
| 1750795803 | Maria Gianna Agustin | Nurse Practitioner | 5618 Jeremy Ln, Jacksonville, FL 32257-3215 | 2014-06-17 |
| 1881021376 | Erika Laine Baker | Nurse Practitioner | 655 W 8th St # C3, Clinical Center 6th Floor, Suite 6-030, Jacksonville, FL 32209-6511 | 2013-09-30 |
| 1598010688 | Gabrielle Rollins | Nurse Practitioner | 10095 Beach Blvd Ste 400, Jacksonville, FL 32246-4776 | 2012-07-16 |
| 1255659629 | Paul Bryan Hofrichter | Nurse Practitioner | 10475 Centruion Parkway, N., Suite 220, Jacksonville, FL 32256 | 2010-05-11 |
| 1306972161 | Robin Paylor Johnson | Nurse Practitioner | 10337 San Jose Blvd Ste 104, Jacksonville, FL 32257-8223 | 2007-02-26 |
| 1760524060 | Lauren Claxton Shivers | Nurse Practitioner | 8351 Westport Road, Jacksonville, FL 32244 | 2007-02-13 |
| 1336191121 | Lori M Olivarez | Nurse Practitioner | 7807 Baymeadows Rd E., Suite 207, Jacksonville, FL 32256 | 2006-05-17 |
| 1568453504 | Dolores C Jones | Nurse Practitioner | 8344 Whitmire Ct, Jacksonville, FL 32216-1159 | 2005-10-31 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32218 |
Please comment or provide details below to improve the information on MRS. SUSAN L EMMERICH.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.