Individual
ROBERT E TERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1420 LONDON RD, SUITE 100, DULUTH, MN 55805-2433
(218) 728-8508
Mailing address
14700 28TH AVE N, SUITE 20, PLYMOUTH, MN 55447-4835
(763) 559-3779
(763) 450-3986
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R107882-4
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
849343000
—
MN
Enumeration date
06/06/2006
Last updated
06/03/2009
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