Basic Information
Provider Information
NPI: 1407113418
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DAY
FirstName: EMILY
MiddleName: MAERE DUNPHY
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 523 N 3RD ST
Address2:  
City: BRAINERD
State: MN
PostalCode: 564013054
CountryCode: US
TelephoneNumber: 2188292861
FaxNumber:  
Practice Location
Address1: 13060 ISLE DR
Address2:  
City: BAXTER
State: MN
PostalCode: 564258331
CountryCode: US
TelephoneNumber: 2188282880
FaxNumber: 2184545916
Other Information
ProviderEnumerationDate: 04/15/2012
LastUpdateDate: 01/07/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000X56520MNY Allopathic & Osteopathic PhysiciansFamily Medicine 

No ID Information.


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