Provider Demographics
NPI:1881554756
Name:OPPEDAHL, EMILY MARIE (LPN)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:MARIE
Last Name:OPPEDAHL
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1760 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:IA
Mailing Address - Zip Code:52302-4005
Mailing Address - Country:US
Mailing Address - Phone:319-369-4340
Mailing Address - Fax:
Practice Address - Street 1:3500 DALTON WAY SW STE 400
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52404-2567
Practice Address - Country:US
Practice Address - Phone:319-369-4340
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-11-13
Last Update Date:2025-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAP50056164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse