Individual
JESSE PAULUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6401 FRANCE AVE S, EDINA, MN 55435-2104
(952) 924-5000
Mailing address
5807 SHERIDAN AVE S, MINNEAPOLIS, MN 55410-2952
(612) 532-0752
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R173756-3
MN
367500000X
Certified Registered Nurse Anesthetist
Primary
90394
MN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/26/2012
Last updated
02/03/2014
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