Individual
SAMUEL R HJORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
8990 SPRINGBROOK DR NW, COON RAPIDS, MN 55433-5884
(763) 398-0099
(763) 398-0124
Mailing address
5585 HENNA CT, PINE SPRINGS, MN 55128-1805
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R1128897
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
07A18HJ
BCBSMN
MN
05
—
981345400
—
MN
Enumeration date
08/10/2005
Last updated
05/15/2008
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