Healthcare Provider Details

I. General information

NPI: 1619661741
Provider Name (Legal Business Name): EMILY OPPMAN MS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2023
Last Update Date: 06/30/2023
Certification Date: 06/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 MEDICAL VILLAGE DR
EDGEWOOD KY
41017-3403
US

IV. Provider business mailing address

1 MEDICAL VILLAGE DR
EDGEWOOD KY
41017-3403
US

V. Phone/Fax

Practice location:
  • Phone: 859-301-9475
  • Fax:
Mailing address:
  • Phone: 574-344-3237
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code170300000X
TaxonomyGenetic Counselor (M.S.)
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: