Provider Demographics
NPI:1174378624
Name:EMMRICH, BRIANNA TAYLOR (PA)
Entity type:Individual
Prefix:
First Name:BRIANNA
Middle Name:TAYLOR
Last Name:EMMRICH
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:19369 US HIGHWAY 19 N APT 315
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33764-3316
Mailing Address - Country:US
Mailing Address - Phone:414-520-9822
Mailing Address - Fax:
Practice Address - Street 1:5398 PARK ST N
Practice Address - Street 2:
Practice Address - City:SAINT PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33709-1041
Practice Address - Country:US
Practice Address - Phone:727-544-1441
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-18
Last Update Date:2024-04-18
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant