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NPI Code Detail

MEDICARE: EMILY KORTZ

MEDICARE: EMILY KORTZ
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program
2363A00000XPhysician Assistant14187MN

General Provider Information

NPI Number : 1669059218
Entity Type Code : Individual
Provider Name (Legal Business Name) : EMILY KORTZ
Provider Business Mailing Address
First Line : 1000 1ST DR NW
Second Line :
City : AUSTIN
State : MN
Zip : 55912-2941
Country : US
Telephone Number : 507-433-5735
Fax Number :
Provider Business Practice Location Address
First Line : 1000 1ST DR NW
Second Line :
City : AUSTIN
State : MN
Zip : 55912-2941
Country : US
Telephone Number : 507-433-5735
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/28/2021
Last Update Date : 06/17/2026

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Directions to “ EMILY KORTZ ” Practice Location

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