Provider Demographics
NPI:1407429905
Name:FREUDENTHAL, EMILY ANN (DNP)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:ANN
Last Name:FREUDENTHAL
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2101 W 69TH ST STE 204A
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57108-5621
Mailing Address - Country:US
Mailing Address - Phone:605-306-2020
Mailing Address - Fax:
Practice Address - Street 1:2101 W 69TH ST STE 204A
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57108-5621
Practice Address - Country:US
Practice Address - Phone:605-306-2020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-21
Last Update Date:2021-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDCP002072363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily