Individual
TERRY NEUBARTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
4035 30TH AVE SW, MONTEVIDEO, MN 56265-4050
(952) 442-9770
Mailing address
400 E 10TH ST, WACONIA, MN 55387-4552
(952) 442-9770
(952) 442-3620
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R078872
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
324719800
—
MN
01
—
4K127NE
BLUE CROSS BLUE SHIELD
MN
Enumeration date
10/25/2005
Last updated
04/28/2008
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