Organization
PARK NICOLLET METHODIST HOSPITAL
Active
Other names
Park Nicollet Methodist Hospital CRNAs
Organization subpart
No
Provider details
NPI number
Authorized official
JASON JAMES LUHRS (VP FINANCE)
(952) 883-7158
Entity
Organization
Contact information
Practice address
6500 EXCELSIOR BLVD, ST LOUIS PARK, MN 55426
(952) 993-5000
(952) 993-1980
Mailing address
14700 28TH AVE N, SUITE 20, PLYMOUTH, MN 55447
(763) 559-3779
(763) 450-3986
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
—
—
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Enumeration date
08/04/2006
Last updated
10/25/2021
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