Provider Demographics
NPI:1154618411
Name:EMERICK, KATHERINE (CNP)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:EMERICK
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2801 MISSOURI AVE
Mailing Address - Street 2:SUITE # 12
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88011-5075
Mailing Address - Country:US
Mailing Address - Phone:575-649-9433
Mailing Address - Fax:575-522-8891
Practice Address - Street 1:2801 MISSOURI AVE
Practice Address - Street 2:SUITE # 12
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88011-5075
Practice Address - Country:US
Practice Address - Phone:575-649-9433
Practice Address - Fax:575-522-8891
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-06
Last Update Date:2011-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCNP-01746363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily