Provider Demographics
NPI:1962937813
Name:MOCK, EMILY (DNP, CRNP-BC)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:MOCK
Suffix:
Gender:F
Credentials:DNP, CRNP-BC
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:
Other - Last Name:STARN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DNP, CRNP-BC
Mailing Address - Street 1:291 STATE ROUTE 288
Mailing Address - Street 2:
Mailing Address - City:ELLWOOD CITY
Mailing Address - State:PA
Mailing Address - Zip Code:16117-5513
Mailing Address - Country:US
Mailing Address - Phone:724-752-8722
Mailing Address - Fax:724-752-5508
Practice Address - Street 1:291 STATE ROUTE 288
Practice Address - Street 2:
Practice Address - City:ELLWOOD CITY
Practice Address - State:PA
Practice Address - Zip Code:16117-5513
Practice Address - Country:US
Practice Address - Phone:724-752-8722
Practice Address - Fax:724-752-5508
Is Sole Proprietor?:No
Enumeration Date:2017-04-28
Last Update Date:2024-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP016831363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily