Individual
BRUCE THOR ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CNP
Contact information
Practice address
6025 LAKE ROAD, SUITE 110, WOODBURY, MN 55125-1709
(651) 735-7414
(651) 735-1827
Mailing address
2550 UNIVERSITY AVE W STE 110N, SAINT PAUL, MN 55114-2001
(651) 602-5309
(651) 222-6786
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
057335
IA
363L00000X
Nurse Practitioner
Primary
R 228559-3
MN
Other
Enumeration date
05/24/2007
Last updated
11/29/2017
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