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Individual

MR. GREGGORY MENTELE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
640 JACKSON ST, SAINT PAUL, MN 55101-2502
(651) 254-6512
Mailing address
200 1ST ST SW, ROCHESTER, MN 55905-0001
(507) 284-2511

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
2047
MN
367500000X
Certified Registered Nurse Anesthetist
D136691
IA
367500000X
Certified Registered Nurse Anesthetist
NA95000441
CA

Other

Enumeration date
05/12/2014
Last updated
07/05/2024
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