Doctor Name: | EMILY MARIE LUITJENS |
NPI Number: | 1245587252 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MS, FNP-BC |
License Number: | 2012010717 |
Business Practice Address: | 25945 Gateway Dr Zimmerman, MN - 553985300 |
Business Phone Number: | 7638566900 |
Business Fax Number: | |
Mailing Address: | 25945 Gateway Dr, ZIMMERMAN |
State: | MN |
Postal Code: | 553985300 |
Phone Number: | 7638566900 |
Fax Number: | |
NPI Enumeration Date: | 08/08/2012 |
NPI Last Update Date: | 12/28/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 2012010717 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MN |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |