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Individual

MARY T SPADES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
6500 EXCELSIOR BLVD, METHODIST HOSPITAL, ST LOUIS PARK, MN 55426-4702
(952) 993-5222
(952) 993-6499
Mailing address
4501 GOLF TER, EDINA, MN 55424-1510
(952) 925-1793
(952) 993-0300

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R 118777-3
MN
367500000X
Certified Registered Nurse Anesthetist
Primary
0357
MN

Other

Enumeration date
01/11/2006
Last updated
12/20/2024
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