Provider Demographics
NPI:1811429871
Name:HAUSE, EMILY
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:HAUSE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2638 LINCOLN ST NE
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55418-3044
Mailing Address - Country:US
Mailing Address - Phone:651-214-8544
Mailing Address - Fax:
Practice Address - Street 1:999 N 92ND ST
Practice Address - Street 2:SUITE 730
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53226-4875
Practice Address - Country:US
Practice Address - Phone:414-266-6680
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-29
Last Update Date:2023-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN674722080P0216X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No2080P0216XAllopathic & Osteopathic PhysiciansPediatricsPediatric Rheumatology