Individual
HAROLD W PEDERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
8990 SPRINGBROOK DR NW, STE 250, COON RAPIDS, MN 55433-5850
(763) 398-0099
(763) 398-0124
Mailing address
395 8TH ST NE, APT 101, MILACA, MN 56353-1678
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R 066992-0
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
696742600
—
MN
01
—
94D43PE
BCBSMN
MN
Enumeration date
08/16/2005
Last updated
05/16/2008
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