Individual
MR. MARK GARY PENZENSTADLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, CRNA
Contact information
Practice address
1 VETERANS DR, MINNEAPOLIS, MN 55417-2309
(612) 725-2119
Mailing address
9632 WASHBURN RD S, BLOOMINGTON, MN 55431-2461
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R1122796
MN
Other
Enumeration date
04/03/2006
Last updated
07/08/2007
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