NPI 1114494002 · live from the CMS NPI Registry
Emily L Koelsch, RN, CPNP-PC
Pediatrics in Fayetteville, AR. National Provider Identifier 1114494002, active.
NPI record
| NPI | 1114494002 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Pediatrics 208000000X |
| Practice location | 3215 N Northhills Blvd, Fayetteville, AR 72703 |
| Practice phone | 781-264-7754 |
| Enumerated | October 29, 2018 |
| Last updated | September 19, 2025 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Pediatrics primary | 208000000X | 227343 (AR) |
| Nurse Practitioner, Pediatrics | 363LP0200X | 95020554 (CA) |
| Nurse Practitioner, Pediatrics | 363LP0200X | RN2303260 (MA) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.