Individual
STEVEN D YDSTIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1025 MARSH ST, MANKATO, MN 56001-4752
(507) 345-2623
(507) 389-4685
Mailing address
10 CAMDEN CT, NORTH MANKATO, MN 56003-4246
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R145489-1
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
023598900
—
MN
01
—
128351
UCARE
—
01
—
2000879
MEDICA
—
01
—
47B51YD
BLUE CROSS BLUE SHIELD
MN
01
—
967551028154
PREFERRED ONE
—
01
—
HP57615
HEALTH PARTNERS
—
Enumeration date
08/30/2006
Last updated
11/13/2024
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