| NPI | 1396098562 | 
|---|---|
| Former Name | EMILY RENEE CUSICK | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CA 22468)  | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CO 1678229)  | 
| 363L00000X Nurse Practitioner (Licence: CA 599565)  | |
| 363LF0000X Nurse Practitioner, Family (Licence: CO 0997112-NP)  | |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: CO 0997112-NP)  | |
| Enumeration Date | 2012-10-24 | 
| Last Update Date | 2023-07-13 |