Individual
JOHN H IMSANDE
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1720 HIGHWAY 59 S, THIEF RIVER FALLS, MN 56701-4331
(218) 681-4747
(218) 683-2595
Mailing address
1720 HIGHWAY 59 S, THIEF RIVER FALLS, MN 56701-4331
(218) 681-4747
(218) 683-2595
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
140578-5
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2003325
MEDICA #
MN
01
—
HP40848
HEALTHPARTNERS #
MN
Enumeration date
05/18/2006
Last updated
07/08/2007
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