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Individual

BRIAN MOSS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
1 VETERANS DR, MINNEAPOLIS, MN 55417-2309
(651) 238-2295
Mailing address
4805 10TH AVE S, MINNEAPOLIS, MN 55417-1101
(651) 238-2295

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R 170476-1
MN
367500000X
Certified Registered Nurse Anesthetist
Primary
083445
MN

Other

Enumeration date
10/28/2009
Last updated
05/25/2022
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