Healthcare Provider Details

I. General information

NPI: 1376061408
Provider Name (Legal Business Name): CHAUNTEL SPALJ ENGEN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CHAUNTEL SPALJ

II. Dates (important events)

Enumeration Date: 09/08/2017
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6401 FRANCE AVE S
EDINA MN
55435-2199
US

IV. Provider business mailing address

7161 FRANCE AVE S APT 413
MINNEAPOLIS MN
55435-4341
US

V. Phone/Fax

Practice location:
  • Phone: 952-924-5000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number2363
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: