Provider Demographics
NPI:1912890898
Name:EMMERT, ERIN EILEEN
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:EILEEN
Last Name:EMMERT
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 1:9610 BURNING TREE DR
Mailing Address - Street 2:
Mailing Address - City:GRAND BLANC
Mailing Address - State:MI
Mailing Address - Zip Code:48439-9568
Mailing Address - Country:US
Mailing Address - Phone:810-869-2298
Mailing Address - Fax:
Practice Address - Street 1:1726 LEONARD ST NE
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49505-5636
Practice Address - Country:US
Practice Address - Phone:616-459-0478
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-30
Last Update Date:2025-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program