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NPI Code Detail

MEDICARE: EMILEE RENEE PREWITT-HAGGARD PMHNP-BC

MEDICARE: EMILEE RENEE PREWITT-HAGGARD PMHNP-BC
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
1363LP0808XPsychiatric/Mental Health Nurse Practitioner4058364KY

General Provider Information

NPI Number : 1891626289
Entity Type Code : Individual
Provider Name (Legal Business Name) : EMILEE RENEE PREWITT-HAGGARD PMHNP-BC
Provider Business Mailing Address
First Line : 140 BRYAN BLVD
Second Line :
City : CORBIN
State : KY
Zip : 40701-2775
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 140 BRYAN BLVD
Second Line :
City : CORBIN
State : KY
Zip : 40701-2775
Country : US
Telephone Number : 606-523-2005
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/26/2026
Last Update Date : 06/02/2026

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