Healthcare Provider Details

I. General information

NPI: 1659280469
Provider Name (Legal Business Name): NUE CORPORATION PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/07/2026
Last Update Date: 09/07/2026
Certification Date: 09/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

159 PETALUMA BLVD N
PETALUMA CA
94952-2904
US

IV. Provider business mailing address

159 PETALUMA BLVD N
PETALUMA CA
94952-2904
US

V. Phone/Fax

Practice location:
  • Phone: 707-775-7393
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: EMILY HAX
Title or Position: OWNER
Credential: FNP
Phone: 415-377-3149