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Individual

BETHANY MARIE UNDIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
701 DELLWOOD ST S, CAMBRIDGE, MN 55008-1920
(763) 689-7700
(763) 689-7941
Mailing address
2925 CHICAGO AVE, MINNEAPOLIS, MN 55407-1321
(612) 262-4813
(612) 262-4194

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R-111730-3
MN

Other

Enumeration date
11/01/2006
Last updated
03/04/2015
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