Individual
TERESA ANN BLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
800 S MAIN AVE, RUGBY, ND 58368-2118
(701) 776-5261
(701) 776-5448
Mailing address
1509 6TH AVE SE, RUGBY, ND 58368-2542
(701) 776-5145
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R22221
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
12538
—
ND
01
—
4014
BLUE CROSS BLUE SHIELD
ND
Enumeration date
03/01/2007
Last updated
07/08/2007
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