Provider Demographics
NPI:1982449773
Name:GINGERICH, EMILY MARGARETE
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:MARGARETE
Last Name:GINGERICH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2216 MIDNIGHT PEARL DR
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34240-2417
Mailing Address - Country:US
Mailing Address - Phone:734-642-8203
Mailing Address - Fax:
Practice Address - Street 1:2216 MIDNIGHT PEARL DR
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34240-2417
Practice Address - Country:US
Practice Address - Phone:734-642-8203
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-25
Last Update Date:2024-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11027449363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner