Provider Demographics
NPI:1669074985
Name:UNTERREINER, EMILY NOE (FNP-BC)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:NOE
Last Name:UNTERREINER
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:STREID
Other - Last Name:NOE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:2002 COUNTY ROAD 205
Mailing Address - Street 2:
Mailing Address - City:DURANGO
Mailing Address - State:CO
Mailing Address - Zip Code:81301-8532
Mailing Address - Country:US
Mailing Address - Phone:970-946-7960
Mailing Address - Fax:
Practice Address - Street 1:1 MERCADO ST STE 100
Practice Address - Street 2:
Practice Address - City:DURANGO
Practice Address - State:CO
Practice Address - Zip Code:81301-7306
Practice Address - Country:US
Practice Address - Phone:970-385-7977
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-11
Last Update Date:2020-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0166511163WX0200X
COAPN.0996082-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
No163WX0200XNursing Service ProvidersRegistered NurseOncologyGroup - Single Specialty