Individual
BENJAMIN O GILLMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
6401 FRANCE AVE S, EDINA, MN 55435-2104
(952) 924-5000
Mailing address
6401 FRANCE AVE S, EDINA, MN 55435-2104
(529) 924-5000
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R174653-8
MN
367500000X
Certified Registered Nurse Anesthetist
Primary
103357
MN
367500000X
Certified Registered Nurse Anesthetist
806
MN
Other
Enumeration date
07/29/2014
Last updated
03/11/2021
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