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Individual

EILEEN M CHANNEL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
323 S MINNESOTA ST, CROOKSTON, MN 56716-1601
(218) 281-9200
(218) 281-9224
Mailing address
323 S MINNESOTA ST, CROOKSTON, MN 56716-1601
(218) 281-9200
(218) 281-9224

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R 148885-4
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
R 148885-4
LICENSE
MN
Enumeration date
10/31/2006
Last updated
02/19/2014
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