Individual
ERIC B ROED
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
323 S MINNESOTA ST, CROOKSTON, MN 56716-1601
(218) 281-9200
(218) 281-9224
Mailing address
400 10TH ST E, WACONIA, MN 55387-4552
(952) 442-9770
(952) 442-3620
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R1488715
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
11929
—
ND
Enumeration date
08/23/2006
Last updated
08/16/2019
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