Provider Demographics
NPI:1346758133
Name:EMSLIE, PATRICIA ANN (AP)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:ANN
Last Name:EMSLIE
Suffix:
Gender:F
Credentials:AP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:86175 COURTNEY ISLES WAY
Mailing Address - Street 2:
Mailing Address - City:YULEE
Mailing Address - State:FL
Mailing Address - Zip Code:32097-3516
Mailing Address - Country:US
Mailing Address - Phone:561-465-1400
Mailing Address - Fax:561-465-1751
Practice Address - Street 1:86175 COURTNEY ISLES WAY
Practice Address - Street 2:
Practice Address - City:YULEE
Practice Address - State:FL
Practice Address - Zip Code:32097-3516
Practice Address - Country:US
Practice Address - Phone:561-465-1400
Practice Address - Fax:561-465-1751
Is Sole Proprietor?:No
Enumeration Date:2018-01-16
Last Update Date:2018-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP2787171100000X
FLMA84699225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty