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General NPI Number Information
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NPI Number | 1184585630
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Entity Type | Individual
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Provider Name | EMILY KATHERINE CRECELIUS FNP
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Gender | Female
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Dates
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Enumeration Date | 11/22/2025
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Last Update Date | 11/22/2025
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Provider Practice Location Address
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Address Line | 313 POPLAR ST
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City | LOOGOOTEE
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State | IN
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Zip | 47553-2423
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Country | US
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Telephone | 812-295-4433
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Fax |
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Provider Business Mailing Address
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Address Line | 10400 CHIPPEWA DR
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City | NEWBURGH
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State | IN
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Zip | 47630-8715
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Country | US
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Telephone | 812-598-7536
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 28202895A
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License Number State | IN
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