Emma Gwynn Crush

Individual provider Active NPI Athletic Trainer · Prospect, KY

NPI 1992398911 · NPPES record last updated Feb 19, 2021

Key facts

NPI
1992398911
Entity type
Individual (NPI type 1)
Primary specialty
Athletic Trainer 2255A2300X
Practice address
6708 Wild Fox LN
Prospect, KY 40059-9479
Phone
(502) 810-4268
NPI assigned
Feb 19, 2021
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)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X Yes

Addresses

Primary practice location

6708 Wild Fox LN
Prospect, KY 40059-9479

Mailing address

6708 Wild Fox LN
Prospect, KY 40059-9479
Phone (502) 810-4268

Other providers in Prospect, KY

All providers in Prospect, KY · Athletic Trainer in Kentucky

Sources for this page

Verify at the official NPI Registry.