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General NPI Number Information
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NPI Number | 1417410846
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Entity Type | Individual
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Provider Name | EMILY ANNE JUST CRNP-BC
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Gender | Female
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Dates
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Enumeration Date | 04/11/2019
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Last Update Date | 08/06/2024
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Provider Practice Location Address
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Address Line | 705 20TH AVE E
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City | JASPER
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State | AL
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Zip | 35501-4071
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Country | US
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Telephone | 205-221-9775
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Fax |
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Provider Business Mailing Address
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Address Line | 705 20TH AVE E
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City | JASPER
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State | AL
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Zip | 35501-4071
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Country | US
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Telephone | 205-221-9775
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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 | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | 3-000631
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | 1-150238
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License Number State | AL
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