Individual
BRENDA J PAYNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
7330 STATE HIGHWAY 7, EXCELSIOR, MN 55331
(651) 257-2251
(651) 257-2261
Mailing address
4137 PARK AVE, MINNEAPOLIS, MN 55407-3128
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R0800747
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
52G97PA
BCBS
MN
Enumeration date
09/16/2006
Last updated
07/08/2007
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