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NPI Code Detail

MEDICARE: KRISTA DENISE EMMETT

MEDICARE: KRISTA DENISE EMMETT
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
1106S00000XBehavior TechnicianAZ

General Provider Information

NPI Number : 1891628707
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTA DENISE EMMETT
Provider Business Mailing Address
First Line : 21837 N 90TH AVE
Second Line :
City : PEORIA
State : AZ
Zip : 85383-2309
Country : US
Telephone Number : 602-329-2668
Fax Number :
Provider Business Practice Location Address
First Line : 17235 N 75TH AVE STE G120
Second Line :
City : GLENDALE
State : AZ
Zip : 85308-0895
Country : US
Telephone Number : 480-812-4789
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/08/2026
Last Update Date : 06/08/2026

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Directions to “ KRISTA DENISE EMMETT ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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