Healthcare Provider Details
I. General information
NPI: 1003244955
Provider Name (Legal Business Name): EMILY FLATHOUSE FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 10/30/2013
Last Update Date: 09/09/2024
Certification Date: 09/09/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7501 QUAKER AVE FL 1
LUBBOCK TX
79424-3367
US
IV. Provider business mailing address
5219 CITY BANK PKWY STE 35
LUBBOCK TX
79407-3545
US
V. Phone/Fax
- Phone: 806-788-3306
- Fax: 806-772-3861
- Phone: 806-761-0333
- Fax: 806-782-0097
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | AP124658 |
| License Number State | TX |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: