Individual
MARIBETH MOECKLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
6500 EXCELSIOR BLVD, ST LOUIS PARK, MN 55426-4702
(952) 993-6016
Mailing address
2505 PENNSYLVANIA AVE S, ST LOUIS PARK, MN 55426-2611
(763) 486-9039
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
12345
MN
Other
Enumeration date
09/17/2021
Last updated
09/17/2021
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