Individual
GRANT THOMAS JORDAN-TAYLOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
500 HARVARD ST SE, MINNEAPOLIS, MN 55455
(612) 229-6713
Mailing address
8 VINCENT AVE S, MINNEAPOLIS, MN 55405-1952
(612) 229-6713
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
86622
MN
Other
Enumeration date
12/21/2010
Last updated
06/05/2018
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