MEDICARE: EMILY HARBISON APNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WG0000X	General Practice Registered Nurse	184745	WI
2	363L00000X	Nurse Practitioner	8679	WI

General Provider Information

NPI Number	:	1043792211
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMILY HARBISON APNP

Provider Business Mailing Address
First Line	:	831 ARTHUR DR
Second Line	:
City	:	MILTON
State	:	WI
Zip	:	53563-3728
Country	:	US
Telephone Number	:	608-868-3526
Fax Number	:	608-868-3527

Provider Business Practice Location Address
First Line	:	831 ARTHUR DR
Second Line	:
City	:	MILTON
State	:	WI
Zip	:	53563-3728
Country	:	US
Telephone Number	:	608-868-3526
Fax Number	:	608-868-3527

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/04/2018
Last Update Date	:	09/04/2018

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