Healthcare Provider Details

I. General information

NPI: 1245086941
Provider Name (Legal Business Name): EMMA GRACE LANHART
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/24/2024
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 DELLWOOD ST S
CAMBRIDGE MN
55008-1920
US

IV. Provider business mailing address

427 EAGLE ST NW
ISANTI MN
55040-4459
US

V. Phone/Fax

Practice location:
  • Phone: 763-689-8700
  • Fax: 763-688-7796
Mailing address:
  • Phone: 763-923-5129
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number528930
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: