Healthcare Provider Details

I. General information

NPI: 1669074985
Provider Name (Legal Business Name): EMILY NOE UNTERREINER FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: EMILY STREID NOE RN

II. Dates (important events)

Enumeration Date: 11/11/2020
Last Update Date: 11/27/2020
Certification Date: 11/27/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 MERCADO ST STE 100
DURANGO CO
81301-7306
US

IV. Provider business mailing address

2002 COUNTY ROAD 205
DURANGO CO
81301-8532
US

V. Phone/Fax

Practice location:
  • Phone: 970-385-7977
  • Fax:
Mailing address:
  • Phone: 970-946-7960
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WX0200X
TaxonomyOncology Registered Nurse
License Number0166511
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPN.0996082-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: