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General NPI Number Information
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NPI Number | 1831609866
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Entity Type | Individual
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Provider Name | EMILY KATHLEEN VERSEMAN FNP
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Gender | Female
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Dates
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Enumeration Date | 10/04/2017
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Last Update Date | 10/04/2017
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Provider Practice Location Address
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Address Line | 212 E 10TH ST
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City | GREENSBURG
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State | IN
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Zip | 47240-8249
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Country | US
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Telephone | 812-222-0970
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Fax | 812-222-0972
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Provider Business Mailing Address
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Address Line | 2866 S 750 E
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City | WALDRON
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State | IN
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Zip | 46182-9710
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Country | US
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Telephone | 317-374-8262
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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 | 28178448A
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License Number State | IN
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