Individual
ANNETTE J COMBO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
8990 SPRINGBROOK DR NW, SUITE 250, COON RAPIDS, MN 55433-5850
(763) 398-1162
(763) 398-0124
Mailing address
16913 80TH PL N, MAPLE GROVE, MN 55311-1796
(763) 398-0099
(763) 398-0124
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R1122055
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
07A16CO
BCBSMN
MN
05
—
248024700
—
MN
Enumeration date
08/09/2005
Last updated
05/15/2008
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