Emily Elizabeth Maytum, FNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

F337466 Issued in NY

Practice address

280 Central Ave
Lograsso Hall Student Health Center
Fredonia, NY 14063-1127

Phone

(716) 673-3131

Fax

(716) 673-4722

NPI assigned

Sep 25, 2012

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Miss Emily Elizabeth Griffith Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1348531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447718400000",
    "number": "1427309814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 CENTRAL AVE",
            "address_2": "LOGRASSO HALL STUDENT HEALTH CENTER",
            "city": "FREDONIA",
            "state": "NY",
            "postal_code": "140631127",
            "telephone_number": "716-673-3131",
            "fax_number": "716-673-4722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 CENTRAL AVE",
            "address_2": "LOGRASSO HALL STUDENT HEALTH CENTER",
            "city": "FREDONIA",
            "state": "NY",
            "postal_code": "140631127",
            "telephone_number": "716-673-3131",
            "fax_number": "716-673-4722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYTUM",
        "first_name": "EMILY",
        "middle_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-25",
        "last_updated": "2015-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "F337466",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EMILY",
            "last_name": "GRIFFITH",
            "middle_name": "ELIZABETH",
            "prefix": "MISS",
            "credential": "FNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jolie Mandell, PT
• Dawn J Manzella, MSED
• Kimberly Marino-Alguire
• Mark Twichell & Annette Lukasik DDS LLP
• Laurie Ann Marucci
• Jessica Maziar
• Tiffany McCarthy, DDS
• Linda Christine McCormick, RN
• Kelly Keenan McCoy, RN
• Deirdre McEntarfer

• Nurse Practitioner in Fredonia, NY
• Providers in Fredonia, NY by specialty
• Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.