DR. MARY SUSAN EMERSON APRN PHD NPI 1790784452

NPI Information

NPI: 1790784452
Provider Name: DR. MARY SUSAN EMERSON, APRN, PHD
Classification: Nurse Practitioner - 363LA2200X
Entity Type: Individual

Specialization: Adult Health

Address:
2616 TUMBLE BROOK DR
LAS VEGAS, NV
ZIP 89134
Phone: (918) 606-0505
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DR. Mary Susan Emerson, APRN, PHD is an adult health nurse practitioner in Las Vegas, NV. DR. Mary Susan Emerson, APRN, PHD NPI is 1790784452. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

2616 TUMBLE BROOK DR
LAS VEGAS, NV
ZIP 89134-869
Phone: (918) 606-0505

The enumeration date for this NPI number is 7/15/2005 and was last updated on 2/17/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LA2200X	Nurse Practitioner	Adult Health	063436	MISSOURI	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	2638309A	MEDICARE ID-TYPE UNSPECIFIED	MISSOURI
2	S53458	MEDICARE UPIN	MISSOURI
3	425324506	MEDICAID	MISSOURI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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