Individual
TRAVIS TANBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
333 SMITH AVE N, SAINT PAUL, MN 55102-2344
(651) 697-5804
Mailing address
333 SMITH AVE N, SAINT PAUL, MN 55102-2344
(651) 697-5804
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
109295
MN
Other
Enumeration date
12/23/2015
Last updated
12/23/2015
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