Provider Demographics
NPI:1902161441
Name:GERMASH, EMILY (LM, CPM)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:GERMASH
Suffix:
Gender:F
Credentials:LM, CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 80
Mailing Address - Street 2:
Mailing Address - City:PEASTER
Mailing Address - State:TX
Mailing Address - Zip Code:76485-0080
Mailing Address - Country:US
Mailing Address - Phone:817-596-5009
Mailing Address - Fax:817-409-1833
Practice Address - Street 1:226 LEE STREET
Practice Address - Street 2:
Practice Address - City:PEASTER
Practice Address - State:TX
Practice Address - Zip Code:76485
Practice Address - Country:US
Practice Address - Phone:817-596-5009
Practice Address - Fax:817-409-1833
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-11
Last Update Date:2012-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX99153176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife