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Individual

NANCY L BULL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
8990 SPRINGBROOK DR NW, STE 250, COON RAPIDS, MN 55433-5850
(763) 398-0099
(763) 398-0124
Mailing address
27500 BISCAYNE AVE, RANDOLPH, MN 55065-9513

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R 066132-6
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
308717400
MN
01
39G16BU
BCBSMN
MN
Enumeration date
08/16/2005
Last updated
05/16/2008
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