Basic Information
Provider Information
NPI: 1467814962
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: EMMERT
FirstName: SHEREE
MiddleName: D.
NamePrefix:  
NameSuffix:  
Credential: NP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
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OtherCredential:  
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Mailing Information
Address1: 1000 N OAK AVE
Address2:  
City: MARSHFIELD
State: WI
PostalCode: 544495703
CountryCode: US
TelephoneNumber: 7153875511
FaxNumber: 7153875240
Practice Location
Address1: 3322 CLAIRE DANIELLE
Address2: MCHS MISSOURI TELEHEALTH - SHEREE EMMERT NP
City: JOPLIN
State: MO
PostalCode: 648043147
CountryCode: US
TelephoneNumber: 7152217323
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/23/2016
LastUpdateDate: 05/02/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 05/02/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000X7671WIY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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