Healthcare Provider Details

I. General information

NPI: 1568089340
Provider Name (Legal Business Name): EMILY ABERNETHY NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2020
Last Update Date: 12/18/2020
Certification Date: 12/18/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 E SUPERIOR ST STE 401
DULUTH MN
55802-2229
US

IV. Provider business mailing address

1001 E SUPERIOR ST STE 401
DULUTH MN
55802-2229
US

V. Phone/Fax

Practice location:
  • Phone: 218-249-7960
  • Fax:
Mailing address:
  • Phone: 218-249-6500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number7495
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: