Healthcare Provider Details

I. General information

NPI: 1750152476
Provider Name (Legal Business Name): EMMCAM CONSULTING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/11/2024
Last Update Date: 10/15/2025
Certification Date: 10/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

109 LINWOOD DR
RIO GRANDE OH
45674
US

IV. Provider business mailing address

PO BOX 312
RIO GRANDE OH
45674-0312
US

V. Phone/Fax

Practice location:
  • Phone: 734-274-2068
  • Fax: 734-822-9688
Mailing address:
  • Phone: 740-645-5755
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name: BRETT ALLEN JONES
Title or Position: NURSE PRACTITIONER
Credential: CNP
Phone: 707-506-0433