Provider Demographics
NPI:1285385880
Name:EMGE, WHITLEY S (NP)
Entity type:Individual
Prefix:
First Name:WHITLEY
Middle Name:S
Last Name:EMGE
Suffix:
Gender:
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:605 ERIE DR
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:IN
Mailing Address - Zip Code:47610-9326
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:605 ERIE DR
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:IN
Practice Address - Zip Code:47610-9326
Practice Address - Country:US
Practice Address - Phone:183-027-8606
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-14
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28198491A363L00000X
IN71012304A363L00000X
IL209.027771363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner