Healthcare Provider Details

I. General information

NPI: 1942579974
Provider Name (Legal Business Name): EMILY MILLER CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: EMILY PICTON

II. Dates (important events)

Enumeration Date: 12/20/2011
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4175 HANOVER PIKE UNIT B1
MANCHESTER MD
21102-1454
US

IV. Provider business mailing address

1302 N MAIN STREET STORE 1
HAMPSTEAD MD
21074
US

V. Phone/Fax

Practice location:
  • Phone: 443-900-2042
  • Fax: 531-200-6430
Mailing address:
  • Phone: 443-900-2042
  • Fax: 531-200-6430

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR244883
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: