Healthcare Provider Details

I. General information

NPI: 1962362046
Provider Name (Legal Business Name): EMILIA ROSE SPALDING RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/12/2025
Last Update Date: 11/12/2025
Certification Date: 11/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2450 RIVERSIDE AVE
MINNEAPOLIS MN
55454-1450
US

IV. Provider business mailing address

2450 RIVERSIDE AVE
MINNEAPOLIS MN
55454-1450
US

V. Phone/Fax

Practice location:
  • Phone: 612-365-9881
  • Fax: 612-273-0886
Mailing address:
  • Phone: 612-365-9881
  • Fax: 612-273-0886

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WN0800X
TaxonomyNeuroscience Registered Nurse
License Number2151300
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: