Healthcare Provider Details

I. General information

NPI: 1821844747
Provider Name (Legal Business Name): EMILY HOTALING
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/30/2024
Last Update Date: 08/02/2024
Certification Date: 08/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5950 ROUTE 6 SUITE 101
TUNKHANNOCK PA
18657
US

IV. Provider business mailing address

5950 ROUTE 6 SUITE 101
TUNKHANNOCK PA
18657
US

V. Phone/Fax

Practice location:
  • Phone: 570-836-4294
  • Fax:
Mailing address:
  • Phone: 570-836-4294
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License NumberRN601252
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP030229
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: