Individual
BETH NICOLE LANGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
640 JACKSON ST, SAINT PAUL, MN 55101-2502
(651) 254-4784
Mailing address
689 KINGFISHER LN APT L, WOODBURY, MN 55125-1847
(651) 738-9702
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
085074
MN
Other
Enumeration date
10/06/2010
Last updated
10/06/2010
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