Provider Demographics
NPI:1174408025
Name:EMMERT, ALISE D (CLD)
Entity type:Individual
Prefix:MRS
First Name:ALISE
Middle Name:D
Last Name:EMMERT
Suffix:
Gender:F
Credentials:CLD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5125 HOWARD CT
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28543-1260
Mailing Address - Country:US
Mailing Address - Phone:330-383-8863
Mailing Address - Fax:
Practice Address - Street 1:5125 HOWARD CT
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28543-1260
Practice Address - Country:US
Practice Address - Phone:330-383-8863
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-08
Last Update Date:2025-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula