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Individual

SCOTT E ENGELSTAD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
523 N 3RD ST, BRAINERD, MN 56401-3054
(218) 829-2861
Mailing address
523 N 3RD ST, BRAINERD, MN 56401-3054
(218) 829-2861

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1497003081
KS
367500000X
Certified Registered Nurse Anesthetist
Primary
55611
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
145989
BCBS OF KS
KS
05
200508500A
KS
01
P00625414
RR MEDICARE GROUP CQ2302
KS
Enumeration date
08/05/2007
Last updated
01/07/2016
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