Individual
DR. BETH ANN STAAB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3601 MINNESOTA DR STE 200, BLOOMINGTON, MN 55435-5202
(612) 879-1000
(612) 879-9116
Mailing address
3601 MINNESOTA DR STE 200, BLOOMINGTON, MN 55435-5202
(612) 879-1000
(612) 879-9116
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
53994
MN
2084N0600X
Clinical Neurophysiology Physician
53994
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002152
STATE
GA
Enumeration date
01/19/2008
Last updated
08/26/2024
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