Healthcare Provider Details

I. General information

NPI: 1023960218
Provider Name (Legal Business Name): MS. EMILY NYAMOITA OPORE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/11/2026
Last Update Date: 02/11/2026
Certification Date: 02/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 HIDDEN LAKES PKWY
GOLDEN VALLEY MN
55422-4286
US

IV. Provider business mailing address

4169 119TH AVE NW
COON RAPIDS MN
55433-1642
US

V. Phone/Fax

Practice location:
  • Phone: 763-588-2750
  • Fax: 717-980-2634
Mailing address:
  • Phone: 717-547-1592
  • Fax: 717-980-2634

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number2544641
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: