Individual
MILTON GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
640 JACKSON STREET, MAIL STOP 11503P, ST PAUL, MN 55101-2502
(651) 254-3456
(651) 254-3048
Mailing address
8100 34TH AVE S, 21110Q, BLOOMINGTON, MN 55425-1672
(952) 883-7961
(952) 883-5395
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R1381951
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
821748300
—
MN
Enumeration date
04/18/2006
Last updated
06/10/2009
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