Provider Demographics
NPI:1598564247
Name:GORRELL, EMMA ELISABETH (BSN,MSN, PMHNP-BC)
Entity type:Individual
Prefix:
First Name:EMMA
Middle Name:ELISABETH
Last Name:GORRELL
Suffix:
Gender:
Credentials:BSN,MSN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3220 FEATHERGRASS CT APT 9304
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78758-7782
Mailing Address - Country:US
Mailing Address - Phone:614-940-7915
Mailing Address - Fax:
Practice Address - Street 1:2520 LONGVIEW ST STE 413
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78705-4257
Practice Address - Country:US
Practice Address - Phone:512-686-1066
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-13
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1025176363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health