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General NPI Number Information
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NPI Number | 1225235195
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Entity Type | Individual
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Provider Name | EMMA RAY ENGEL PMHNP
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Gender | Female
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Dates
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Enumeration Date | 07/02/2007
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Last Update Date | 07/02/2025
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Provider Practice Location Address
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Address Line | 11741 SIZEMORE LN
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City | LAWRENCEVILLE
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State | IL
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Zip | 62439-4469
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Country | US
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Telephone | 812-881-5468
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Fax |
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Provider Business Mailing Address
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Address Line | 11741 SIZEMORE LN
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City | LAWRENCEVILLE
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State | IL
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Zip | 62439-4469
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Country | US
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Telephone | 812-316-2419
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Fax | 216-249-9013
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 209018425
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License Number State | IL
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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 | 71003062A
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License Number State | IN
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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 | 277002801
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License Number State | IL
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Taxonomy #4
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Taxonomy Code | 364S00000X
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Taxonomy Name | Clinical Nurse Specialist
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License Number | PENDING
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License Number State | IN
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Taxonomy #5
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Taxonomy Code | 364SP0808X
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Taxonomy Name | Psychiatric/Mental Health Clinical Nurse Specialist
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License Number | 277002801
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License Number State | IL
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