Provider Demographics
NPI:1023662020
Name:BLAU, EMILY KATHRYNE (DNP, FNP)
Entity type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:KATHRYNE
Last Name:BLAU
Suffix:
Gender:F
Credentials:DNP, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:426 S SOLOMON
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85204-2629
Mailing Address - Country:US
Mailing Address - Phone:602-502-9047
Mailing Address - Fax:
Practice Address - Street 1:1510 E FLOWER ST
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85014-5698
Practice Address - Country:US
Practice Address - Phone:602-530-6900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-29
Last Update Date:2019-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ230064363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily