Provider Demographics
NPI:1194522219
Name:RUCKERT, EMMA KRISTINA (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:EMMA
Middle Name:KRISTINA
Last Name:RUCKERT
Suffix:
Gender:
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 CHILDRENS LN
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23507-1971
Mailing Address - Country:US
Mailing Address - Phone:757-735-9508
Mailing Address - Fax:
Practice Address - Street 1:171 KEMPSVILLE RD BLDG B
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23502-4732
Practice Address - Country:US
Practice Address - Phone:757-668-6500
Practice Address - Fax:757-668-6505
Is Sole Proprietor?:No
Enumeration Date:2025-02-26
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024193164363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily