Organization
ST. JOSEPH'S MEDICAL CENTER
Active
Parent organization
ESSENTIA HEALTH
Other names
St. Joseph's Medical Center Anesthesia Associates
Organization subpart
Yes
Provider details
NPI number
Legal business name
ESSENTIA HEALTH
Authorized official
KEVIN BOREN (VP OF FINANCE)
(218) 786-1009
Entity
Organization
Contact information
Practice address
523 N 3RD ST, BRAINERD, MN 56401-3054
(218) 829-2861
(218) 828-3103
Mailing address
14700 28TH AVE N, SUITE 20, PLYMOUTH, MN 55447-4835
(763) 559-3779
(763) 559-3791
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
347060
MN
367500000X
Certified Registered Nurse Anesthetist
347060
MN
Other
Enumeration date
04/20/2010
Last updated
02/26/2024
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