Provider Demographics
NPI:1043985435
Name:FORD, EMILY ANN (NP-C)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:ANN
Last Name:FORD
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:ANN
Other - Last Name:AUCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:24315 SUPERIOR DR
Mailing Address - Street 2:
Mailing Address - City:ROGERS
Mailing Address - State:MN
Mailing Address - Zip Code:55374-4792
Mailing Address - Country:US
Mailing Address - Phone:605-212-2510
Mailing Address - Fax:
Practice Address - Street 1:225 SMITH AVE N STE 400
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55102-2568
Practice Address - Country:US
Practice Address - Phone:651-292-0007
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-09
Last Update Date:2021-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN7773363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty