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NPI Code Detail

MEDICARE: EMILY K ROESLER PA-C

MEDICARE: EMILY K ROESLER PA-C
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
1363A00000XPhysician Assistant

General Provider Information

NPI Number : 1528889771
Entity Type Code : Individual
Provider Name (Legal Business Name) : EMILY K ROESLER PA-C
Provider Business Mailing Address
First Line : 1111 LEFFINGWELL AVE NE
Second Line :
City : GRAND RAPIDS
State : MI
Zip : 49525-6406
Country : US
Telephone Number : 616-459-7101
Fax Number : 616-464-6170
Provider Business Practice Location Address
First Line : 1400 MERCY DR STE 100
Second Line :
City : MUSKEGON
State : MI
Zip : 49444-1833
Country : US
Telephone Number : 231-733-1326
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/21/2024
Last Update Date : 06/24/2026

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Directions to “ EMILY K ROESLER PA-C” Practice Location

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