Individual
BECCA EBBA LUNDBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
701 PARK AVE, MINNEAPOLIS, MN 55415-1623
(612) 873-3152
(612) 904-4218
Mailing address
701 PARK AVE, MINNEAPOLIS, MN 55415-1623
(612) 873-6005
(612) 630-8242
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
042161
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
095242700
—
MN
01
—
233R2LU
BLUE CROSS BLUE SHIELD
MN
01
—
430066278
RAILROAD MEDICARE
MN
01
—
P00430495
RAILROAD MEDICARE
MN
Enumeration date
07/03/2006
Last updated
10/22/2014
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