Keith C Andersen, CRNA
Nurse Anesthetist, Certified Registered in Saint Paul, MN. Individual provider (NPI-1).
NPI number1629177407
StatusActive
Last updated in NPPESJun 14, 2010
Details
- NPI
- 1629177407
- Entity type
- Individual (NPI-1)
- Name
- Keith C Andersen
- Credential
- CRNA
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Sep 21, 2006
- Last updated
- Jun 14, 2010
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | R1107740 | MN | Yes |
Practice location
69 Exchange St WSaint Paul, MN 55102-1004
Phone 651-735-0501 · Fax 651-735-1870
Mailing address
8681 Eagle Point BlvdLake Elmo, MN 55042-8628
Phone 651-251-0821 · Fax 651-251-8050
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