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General NPI Number Information
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NPI Number | 1134536709
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Entity Type | Individual
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Provider Name | EMILY J WOUK MSN, FPMHNP, FNP
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Gender | Female
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Dates
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Enumeration Date | 07/16/2014
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Last Update Date | 04/12/2023
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Provider Practice Location Address
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Address Line | 1300 E BRADFORD PKWY
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City | SPRINGFIELD
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State | MO
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Zip | 65804-4264
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Country | US
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Telephone | 417-761-5000
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Fax | 417-761-5111
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Provider Business Mailing Address
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Address Line | 1300 E BRADFORD PKWY
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City | SPRINGFIELD
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State | MO
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Zip | 65804-4264
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Country | US
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Telephone | 417-761-5000
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Fax | 417-761-5111
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 2009022778
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 2014022536
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License Number State | MO
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 2014022536
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License Number State | MO
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