Organization
MRS SANDMAN LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARISSA JO QUNELL CRNA, APRN (CRNA)
(612) 558-8108
Entity
Organization
Contact information
Practice address
1526 NORTHWAY DR, SAINT CLOUD, MN 56303-1255
(612) 558-8108
Mailing address
8095 TRAIL HAVEN RD, CORCORAN, MN 55340-8803
(612) 558-8108
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
742
MN
Other
Enumeration date
08/21/2018
Last updated
08/21/2018
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