Individual provider Active NPI

Emma Ruth Clynch, RN

  • Registered Nurse
  • Red Wing, MN
National Provider Identifier
1740586304
Registry record updated Jan 31, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
R107639-2 Issued in MN
Practice address
426 West Ave
Red Wing, MN 55066-2473
Phone
(651) 385-6180
Fax
(651) 385-6195
NPI assigned
Jan 31, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X R107639-2 MN Primary

Addresses

Primary practice location

426 West Ave
Red Wing, MN 55066-2473

Mailing address

426 West Ave
Red Wing, MN 55066-2473
Phone (651) 385-6180

Other names 1

  • Teri Clynch Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
R107639-2MNMDRegistered Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1296432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1296432000000",
    "number": "1740586304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "426 WEST AVE",
            "city": "RED WING",
            "state": "MN",
            "postal_code": "550662473",
            "telephone_number": "651-385-6180",
            "fax_number": "651-385-6195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "426 WEST AVE",
            "city": "RED WING",
            "state": "MN",
            "postal_code": "550662473",
            "telephone_number": "651-385-6180",
            "fax_number": "651-385-6195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLYNCH",
        "first_name": "EMMA",
        "middle_name": "RUTH",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-31",
        "last_updated": "2011-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MN",
            "license": "R107639-2",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TERI",
            "last_name": "CLYNCH",
            "credential": "RN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Red Wing, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.