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General NPI Number Information
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NPI Number | 1083120091
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Entity Type | Individual
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Provider Name | EMILY M POLUS MSN
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Gender | Female
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Dates
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Enumeration Date | 12/28/2017
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Last Update Date | 05/02/2025
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Provider Practice Location Address
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Address Line | 142 E MAUMEE ST
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City | ADRIAN
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State | MI
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Zip | 49221-2735
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Country | US
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Telephone | 517-263-5810
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Fax |
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Provider Business Mailing Address
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Address Line | 4747 MONROE ST
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City | TOLEDO
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State | OH
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Zip | 43623-4307
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Country | US
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Telephone | 419-740-5709
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 0031875
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 4704409510
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | RN.419216
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License Number State | OH
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