Healthcare Provider Details

I. General information

NPI: 1427830926
Provider Name (Legal Business Name): EMILY ANN DARY CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: EMILY ANN JAGMIN

II. Dates (important events)

Enumeration Date: 10/18/2023
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

N9613 FRIENDSHIP DR APT 8
KAUKAUNA WI
54130-8557
US

IV. Provider business mailing address

N9613 FRIENDSHIP DR APT 8
KAUKAUNA WI
54130-8557
US

V. Phone/Fax

Practice location:
  • Phone: 847-707-6720
  • Fax:
Mailing address:
  • Phone: 847-707-6720
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number26596430
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number157411
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: