Individual
MS. CAROL RUTH MYSLIVECEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1 VETERANS DR, MINNEAPOLIS, MN 55417-2309
(612) 725-2119
(612) 727-5961
Mailing address
5225 MADDOX LN, EDINA, MN 55436-2602
(952) 285-5649
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R113034-8
MN
Other
Enumeration date
08/04/2006
Last updated
07/08/2007
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