Provider Demographics
NPI:1861377350
Name:LYDA, EMMEANNA SUSAN (DC)
Entity type:Individual
Prefix:DR
First Name:EMMEANNA
Middle Name:SUSAN
Last Name:LYDA
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:EMMEANNA
Other - Middle Name:SUSAN
Other - Last Name:BRANDT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:492 BELVIDERE ST E
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55107-2404
Mailing Address - Country:US
Mailing Address - Phone:320-582-7250
Mailing Address - Fax:
Practice Address - Street 1:3712 CEDAR AVE S
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55407-2939
Practice Address - Country:US
Practice Address - Phone:320-582-7250
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-06
Last Update Date:2025-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN7362111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty