Individual
CASI MARIE SHORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
640 JACKSON ST, SAINT PAUL, MN 55101-2502
(651) 254-6512
Mailing address
629 EASTGATE PKWY, MAHTOMEDI, MN 55115-1737
(302) 824-1048
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
2364728
MN
367500000X
Certified Registered Nurse Anesthetist
Primary
2543
MN
Other
Enumeration date
09/22/2020
Last updated
01/08/2021
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