Individual
ROBERT S WALDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
800 E 28TH ST, MINNEAPOLIS, MN 55407-3723
(612) 863-4000
Mailing address
3479 142ND LN NW, ANDOVER, MN 55304-3245
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
632
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
217288700
—
MN
01
—
375R2WA
BCBSMN
MN
Enumeration date
08/15/2005
Last updated
03/23/2018
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