Provider Demographics
NPI:1841509973
Name:NUNES, EMILY L (PA-C)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:L
Last Name:NUNES
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1309
Mailing Address - Street 2:8170 33RD AVE S
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55425-4516
Mailing Address - Country:US
Mailing Address - Phone:715-243-7224
Mailing Address - Fax:715-246-2162
Practice Address - Street 1:250 RICHMOND WAY
Practice Address - Street 2:
Practice Address - City:NEW RICHMOND
Practice Address - State:WI
Practice Address - Zip Code:54017-6829
Practice Address - Country:US
Practice Address - Phone:715-243-7224
Practice Address - Fax:715-246-2162
Is Sole Proprietor?:No
Enumeration Date:2010-10-07
Last Update Date:2016-02-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MN1489363AM0700X
WI3717-23363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1841509973OtherUCARE
MN1841509973OtherUCARE