Provider Demographics
NPI:1174000178
Name:ERNST, EMILY K (ARNP)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:K
Last Name:ERNST
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:K
Other - Last Name:ROUTH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:EMILY ROUTH
Mailing Address - Street 1:2213 TRAIL VIEW ST
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98506
Mailing Address - Country:US
Mailing Address - Phone:206-713-2000
Mailing Address - Fax:
Practice Address - Street 1:4055 GATEWAY BLVD
Practice Address - Street 2:
Practice Address - City:NEWBURGH
Practice Address - State:IN
Practice Address - Zip Code:47630-7451
Practice Address - Country:US
Practice Address - Phone:812-842-2210
Practice Address - Fax:812-842-4599
Is Sole Proprietor?:No
Enumeration Date:2018-07-23
Last Update Date:2024-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP61046894363L00000X, 363L00000X
IN71015295A363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty