Healthcare Provider Details

I. General information

NPI: 1003739541
Provider Name (Legal Business Name): EMILY GRAEN DNP, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 08/03/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

303 E NICOLLET BLVD STE 200
BURNSVILLE MN
55337-4834
US

IV. Provider business mailing address

18341 GLEED RD
LAKEVILLE MN
55044-4828
US

V. Phone/Fax

Practice location:
  • Phone: 952-460-4000
  • Fax:
Mailing address:
  • Phone: 585-733-1866
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number14533
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: