Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | D0079300 | MD |
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | 63455 | MN |
NPI | 1356640031 |
---|---|
Provider Name | Dr. Emily Nicole Bernice Myer |
First Address | Woodbury, MN 55125-3046 |
Second Address | Woodbury, MN 55125-3046 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/03/2011 |
Last Update Date | 24/01/2019 |