Emma Bacon

Individual provider Active NPI Physician Assistant · Terre Haute, IN

NPI 1669322939 · NPPES record last updated Jan 28, 2026

Key facts

NPI
1669322939
Entity type
Individual (NPI type 1)
Primary specialty
Physician Assistant 363A00000X
Practice address
567 N 5TH St
Terre Haute, IN 47809-1903
Phone
(616) 292-9228
NPI assigned
Jan 28, 2026
Sex
Female
Sole proprietor
Yes

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)CodeLicenseStatePrimary
Physician Assistant 363A00000X Yes

Addresses

Primary practice location

567 N 5TH St
Terre Haute, IN 47809-1903

Mailing address

4915 Tiamo LN NE
Rockford, MI 49341-7714
Phone (616) 292-9228

Other providers in Terre Haute, IN

All providers in Terre Haute, IN · Physician Assistant in Indiana

Sources for this page

Verify at the official NPI Registry.