Provider Demographics
NPI:1912372129
Name:MARTHALER, EMILY ERIN (CRNA)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:ERIN
Last Name:MARTHALER
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:729 FOREST DALE RD
Mailing Address - Street 2:
Mailing Address - City:NEW BRIGHTON
Mailing Address - State:MN
Mailing Address - Zip Code:55112-2529
Mailing Address - Country:US
Mailing Address - Phone:701-367-1968
Mailing Address - Fax:
Practice Address - Street 1:729 FOREST DALE RD
Practice Address - Street 2:
Practice Address - City:NEW BRIGHTON
Practice Address - State:MN
Practice Address - Zip Code:55112-2529
Practice Address - Country:US
Practice Address - Phone:701-367-1968
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-14
Last Update Date:2018-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNCRNA 1862367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered