Individual
PETER YDSTIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1095 HIGHWAY 15 S, HUTCHINSON, MN 55350-5000
(320) 234-4603
Mailing address
400 E 10TH ST, WACONIA, MN 55387-4552
(952) 442-9770
(952) 442-3630
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R104550-1
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
56D99YD
BLUE CROSS OF MN
MN
05
—
694243100
—
MN
Enumeration date
06/25/2006
Last updated
04/29/2008
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