Emily Marie Reisdorf, DNP, APRN,CNP, FNP-C
Nurse Practitioner, Family in Shakopee, MN. Individual provider (NPI-1).
NPI number1326883182
StatusActive
Last updated in NPPESNov 4, 2024
Details
- NPI
- 1326883182
- Entity type
- Individual (NPI-1)
- Name
- Emily Marie Reisdorf
- Credential
- DNP, APRN,CNP, FNP-C
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jun 25, 2024
- Certification date
- Nov 4, 2024
- Last updated
- Nov 4, 2024
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - NURSE PRACTITIONER
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice No
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | 11708 | MN | Yes |
Practice location
4201 Dean Lakes Blvd Ste 120Shakopee, MN 55379-2850
Phone 952-496-6700 · Fax 952-445-6448
Mailing address
4201 Dean Lakes Blvd Ste 120Shakopee, MN 55379-2850
Phone 952-496-6700
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 19 Family Nurse Practitioner providers in Shakopee · All 901 providers in Shakopee
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