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Individual

EMILY KATE WILD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CNP

Contact information

Practice address
20 5TH ST SE, COOK, MN 55723-9702
(218) 666-5941
Mailing address
4396 OAKHURST AVE, VADNAIS HEIGHTS, MN 55127-3589
(218) 591-1678

Taxonomy

Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
2224114
MN
363LF0000X
Family Nurse Practitioner
Primary
9689
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
9689
MINNESOTA BOARD OF NURSING
MN
Enumeration date
03/17/2022
Last updated
11/06/2022
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