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Individual

JONATHAN B ANDERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
824 N 11TH ST, MONTEVIDEO, MN 56265-1629
(320) 269-8878
(952) 442-3620
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
R 206977-7
MN

Other

Enumeration date
04/06/2012
Last updated
04/25/2012
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