Provider Demographics
NPI:1386401289
Name:MCDONALD, EMILY LYNN
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:LYNN
Last Name:MCDONALD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46803 PRAIRIE VIEW ST
Mailing Address - Street 2:
Mailing Address - City:CROOKS
Mailing Address - State:SD
Mailing Address - Zip Code:57020-6009
Mailing Address - Country:US
Mailing Address - Phone:605-838-9301
Mailing Address - Fax:
Practice Address - Street 1:46803 PRAIRIE VIEW ST
Practice Address - Street 2:
Practice Address - City:CROOKS
Practice Address - State:SD
Practice Address - Zip Code:57020-6009
Practice Address - Country:US
Practice Address - Phone:605-838-9301
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-06
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program