Individual
HANNA IONA SANDSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, CRNA, MS
Contact information
Practice address
640 JACKSON ST, ST. PAUL, MN 55101
(651) 254-3456
Mailing address
PO BOX 1309, MAIL STOP 21110Q, MINNEAPOLIS, MN 55440-1309
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R190418-9
MN
163W00000X
Registered Nurse
R34561
ND
367500000X
Certified Registered Nurse Anesthetist
Primary
111885
MN
Other
Enumeration date
09/07/2016
Last updated
09/07/2016
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