Individual
MRS. TRACI JO SALVESON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1406 6TH AVE N, SAINT CLOUD, MN 56303-1900
(320) 258-3090
(320) 258-3095
Mailing address
7616 STATE HIGHWAY 55, KIMBALL, MN 55353-9607
(763) 439-1911
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
2056887
MN
367500000X
Certified Registered Nurse Anesthetist
Primary
2519
MN
Other
Enumeration date
08/11/2020
Last updated
09/22/2020
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