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Organization
FAIRVIEW
Active
Organization
FAIRVIEW
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JILL KATHLEEN PAYNE (CRNA)
(507) 398-4791
Entity
Organization
Contact information
Practice address
21282 INSPIRATION CT, LAKEVILLE, MN 55044-6027
(507) 398-4791
Mailing address
21282 INSPIRATION CT, LAKEVILLE, MN 55044-6027
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
R 169601-5
MN
Other
Enumeration date
08/18/2011
Last updated
10/14/2011
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