Individual
RUSSELL EDWARD O'CONNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN, CRNA
Contact information
Practice address
400 E 3RD ST, ESSENTIA HEALTH DULUTH CLINIC, DULUTH, MN 55805-1951
(218) 786-8364
Mailing address
400 E 3RD ST, ESSENTIA HEALTH DULUTH CLINIC MCL2CRED, DULUTH, MN 55805-1951
(218) 786-1183
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
CRNA 1779
MN
367500000X
Certified Registered Nurse Anesthetist
Primary
R122772-7
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
942015100
—
MN
Enumeration date
05/25/2006
Last updated
11/09/2016
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