Individual
BRADLEY HIIVALA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
6500 EXCELSIOR BLVD, ST LOUIS PARK, MN 55426-4702
(952) 993-3123
Mailing address
8170 33RD AVE S # MS 21110Q, BLOOMINGTON, MN 55425-4516
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
2139746
MN
367500000X
Certified Registered Nurse Anesthetist
Primary
2410
MN
Other
Enumeration date
08/22/2019
Last updated
03/10/2021
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