Provider Demographics
NPI:1326874595
Name:EMERY, KELSEY (CRNP)
Entity type:Individual
Prefix:
First Name:KELSEY
Middle Name:
Last Name:EMERY
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5001 DONNA DR
Mailing Address - Street 2:
Mailing Address - City:COPLAY
Mailing Address - State:PA
Mailing Address - Zip Code:18037-2614
Mailing Address - Country:US
Mailing Address - Phone:570-417-3451
Mailing Address - Fax:
Practice Address - Street 1:5649 WYNNEWOOD DR STE 203
Practice Address - Street 2:
Practice Address - City:LAURYS STATION
Practice Address - State:PA
Practice Address - Zip Code:18059-1124
Practice Address - Country:US
Practice Address - Phone:610-261-1123
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-12
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP030185363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily