Kendall Petty CRNA

NPI 1720287154 - Nurse Anesthetist, Certified Registered - 367500000X

NPI Details
NPI 1720287154
Gender Male
Enumeration Date 07/16/2007
Last Updated 05/19/2008
Entity Type Individual
Active Over 9 years ago
Practice Location
8990 SPRINGBROOK DR NW
SUITE 250
COON RAPIDS MN, 55433-5850, US
Phone (763) 398-0099
Fax (763) 398-0124
Business Location
8990 SPRINGBROOK DR NW
SUITE 250
COON RAPIDS MN, 55433-5850, US
Phone (763) 398-0099
Fax (763) 398-0124
Toxanomy
Taxonomy Code 367500000X
License State Minnesota
License Number R 135220-7
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According to our database, Kendall Petty CRNA NPI is 1720287154, taxonomy code is 367500000X and license number is R 135220-7, license state is located at Minnesota. Kendall Petty CRNA physically located at 8990 Springbrook Dr Nw, Coon Rapids MN, 55433-5850. NPI Number Kendall Petty CRNA has the Individual type.

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1720287154 NPI number is provided on an as is basis without warranty of any kind. 1720287154 is maintained by the National Plan & Provider Enumeration System. The contents of Kendall Petty CRNA are for informational purposes only.