Basic Information
Provider Information
NPI: 1578911228
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: NASH
FirstName: EMMA
MiddleName: CHRISTINE
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3301 W FOREST HOME AVE
Address2:  
City: MILWAUKEE
State: WI
PostalCode: 532152843
CountryCode: US
TelephoneNumber: 4146496000
FaxNumber:  
Practice Location
Address1: 2900 W OKLAHOMA AVE
Address2:  
City: MILWAUKEE
State: WI
PostalCode: 532154330
CountryCode: US
TelephoneNumber: 4146496000
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/02/2016
LastUpdateDate: 11/22/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 11/22/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207P00000XMD-45412IAN Allopathic & Osteopathic PhysiciansEmergency Medicine 
207P00000X31824NEN Allopathic & Osteopathic PhysiciansEmergency Medicine 
207PE0004XR-10514IAN Allopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services
207P00000X75827WIY Allopathic & Osteopathic PhysiciansEmergency Medicine 

No ID Information.


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