Healthcare Provider Details

I. General information

NPI: 1942169909
Provider Name (Legal Business Name): CORE HEALTH MEDICAL AND MENTAL HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/16/2026
Last Update Date: 01/16/2026
Certification Date: 01/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5200 WILLSON RD STE 150
MINNEAPOLIS MN
55424-1300
US

IV. Provider business mailing address

5200 WILLSON RD STE 150
MINNEAPOLIS MN
55424-1300
US

V. Phone/Fax

Practice location:
  • Phone: 952-221-4780
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DR. EMMANUELA AKUDO ENYINNAYA
Title or Position: NURSE PRACTITIONER
Credential: DNP, CNP
Phone: 612-396-5756