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NPI Code Detail

MEDICARE: EMMA WALDE CAA

MEDICARE: EMMA WALDE CAA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1367H00000XAnesthesiologist Assistant2000-00006NC
2207L00000XAnesthesiology Physician75000096AIN

General Provider Information

NPI Number : 1770243016
Entity Type Code : Individual
Provider Name (Legal Business Name) : EMMA WALDE CAA
Provider Business Mailing Address
First Line : 2030 FRANKFORT AVE UNIT 322
Second Line :
City : LOUISVILLE
State : KY
Zip : 40206-4005
Country : US
Telephone Number : 717-357-1315
Fax Number :
Provider Business Practice Location Address
First Line : 1850 STATE ST
Second Line :
City : NEW ALBANY
State : IN
Zip : 47150-4990
Country : US
Telephone Number : 812-944-7701
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/28/2021
Last Update Date : 01/12/2026

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Directions to “ EMMA WALDE CAA” Practice Location

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