Individual
THOMAS JOSEPH GENDRON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CNOR, OPA-C
Contact information
Practice address
775 PRAIRIE CENTER DR, SUITE 250, EDEN PRAIRIE, MN 55344-7314
(952) 944-2519
(952) 944-0460
Mailing address
6465 WAYZATA BLVD, SUITE 900, ST LOUIS PARK, MN 55426-1728
(952) 512-5600
(952) 512-5650
Taxonomy
Speciality
Code
Description
License number
State
163WR0006X
Registered Nurse First Assistant
Primary
1110737
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
55A73GE
BLUE CROSS BLUE SHIELD
—
01
—
969991001287
PREFERREDONE
—
01
—
HP49823
HEALTHPARTNERS
—
Enumeration date
08/24/2006
Last updated
05/24/2022
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