Provider Demographics
NPI:1548868367
Name:HAN, EMILY (CRNP)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:HAN
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 CORPORATE CENTER DR STE 100
Mailing Address - Street 2:
Mailing Address - City:CAMP HILL
Mailing Address - State:PA
Mailing Address - Zip Code:17011-1758
Mailing Address - Country:US
Mailing Address - Phone:717-763-1174
Mailing Address - Fax:717-763-8960
Practice Address - Street 1:4660 WILKENS AVE STE 205
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21229-4846
Practice Address - Country:US
Practice Address - Phone:410-650-4121
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-14
Last Update Date:2025-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR215372363L00000X
PASP027637363LG0600X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner