Provider Demographics
NPI:1447933031
Name:DENNIS, EMILY P (PA-C)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:P
Last Name:DENNIS
Suffix:
Gender:
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30488 MILFORD RD
Mailing Address - Street 2:
Mailing Address - City:NEW HUDSON
Mailing Address - State:MI
Mailing Address - Zip Code:48165-8583
Mailing Address - Country:US
Mailing Address - Phone:734-834-0341
Mailing Address - Fax:
Practice Address - Street 1:30488 MILFORD RD
Practice Address - Street 2:
Practice Address - City:NEW HUDSON
Practice Address - State:MI
Practice Address - Zip Code:48165-8583
Practice Address - Country:US
Practice Address - Phone:248-437-4625
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-09
Last Update Date:2025-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5601011899363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant