Emma Roush
Individual provider Active NPI Physician Assistant · Keswick, IA
NPI 1376355081 · NPPES record last updated Jan 21, 2025
Key facts
- NPI
- 1376355081
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- Practice address
- 10316 170TH Ave
Keswick, IA 50136-9011 - Phone
- (641) 295-1308
- NPI assigned
- Jan 21, 2025
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | Yes |
Addresses
Primary practice location
10316 170TH Ave
Keswick, IA 50136-9011
Mailing address
10316 170TH Ave
Keswick, IA 50136-9011
Phone (641) 295-1308
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 21, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.