Provider Demographics
NPI:1548945363
Name:MARTINSON, EMILY LYNN
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:LYNN
Last Name:MARTINSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44857 NITCHE LAKE RD
Mailing Address - Street 2:
Mailing Address - City:PERHAM
Mailing Address - State:MN
Mailing Address - Zip Code:56573-8873
Mailing Address - Country:US
Mailing Address - Phone:218-457-0240
Mailing Address - Fax:
Practice Address - Street 1:44857 NITCHE LAKE RD
Practice Address - Street 2:
Practice Address - City:PERHAM
Practice Address - State:MN
Practice Address - Zip Code:56573-8873
Practice Address - Country:US
Practice Address - Phone:218-457-0240
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-19
Last Update Date:2023-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program