EMERALD BRIDGE WELLNESS PLLC
NPI 1861233421
Nurse Practitioner - Psychiatric/Mental Health in Prior Lake, MN
Active since June 05, 2024
About Emerald Bridge Wellness Pllc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
EMERALD BRIDGE WELLNESS PLLC (NPI 1861233421) is a healthcare organization registered as a psychiatric/mental health in Prior Lake, Minnesota and active in the NPI registry since June 2024. The organization lists Al Berry, Manager, as its authorized official.
NPPES Registry Identity
NPI1861233421
Entity TypeOrganization
Primary Taxonomy363LP0808X
Legal Business NameEMERALD BRIDGE WELLNESS PLLC
Location Address14033 COMMERCE AVE NE STE 300Prior Lake, MN 55372-1515
Mailing Address14033 Commerce Ave Ne Ste 300Prior Lake, MN 55372-1515 · (512) 763-7086
Phone(512) 763-7086
Organization SubpartNo
Authorized OfficialAl BerryManager · (469) 915-4211
Enumeration DateJune 5, 2024
Last NPPES UpdateMarch 2, 20252 updates tracked since enumeration
NPPES CertifiedMarch 2, 2025
✔ NPI 1861233421 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses
★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
14033 COMMERCE AVE NE STE 300, Prior Lake, MN 55372
Group Practice 1
Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1861233421, enumerated as an "organization" on June 05, 2024.
The provider is located at 14033 COMMERCE AVE NE STE 300 PRIOR LAKE, MN 55372 and the phone number is (512) 763-7086.
Nurse Practitioner with taxonomy code 363LP0808X and a focus in Psychiatric/Mental Health.
