Provider Demographics
NPI:1326361247
Name:NOLD, EMILY PAULINE (PT)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:PAULINE
Last Name:NOLD
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6515 BARRIE RD STE 100
Mailing Address - Street 2:
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55435-2364
Mailing Address - Country:US
Mailing Address - Phone:952-922-5019
Mailing Address - Fax:952-922-1384
Practice Address - Street 1:6515 BARRIE RD
Practice Address - Street 2:100
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435-2363
Practice Address - Country:US
Practice Address - Phone:952-922-5019
Practice Address - Fax:952-922-1384
Is Sole Proprietor?:No
Enumeration Date:2010-03-05
Last Update Date:2019-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT36513225100000X
MN8910225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist