Individual
AMY J IRVIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
657 HILLSIDE DR, EAGAN, MN 55121-2354
(651) 681-7925
Mailing address
657 HILLSIDE DR, EAGAN, MN 55121-2354
(651) 681-7925
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
46009
MN
207P00000X
Emergency Medicine Physician
Primary
M7292
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
187585801
—
TX
05
—
422926600
—
MN
01
—
8S5979
BCBS
TX
Enumeration date
01/06/2006
Last updated
01/03/2008
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