Healthcare Provider Details

I. General information

NPI: 1265737647
Provider Name (Legal Business Name): KARI ANN ALLEN RN, CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/17/2011
Last Update Date: 01/17/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 E 28TH ST 11105
MINNEAPOLIS MN
55407-3723
US

IV. Provider business mailing address

1579 COUNTY ROAD D E UNIT K
MAPLEWOOD MN
55109-5340
US

V. Phone/Fax

Practice location:
  • Phone: 612-863-5213
  • Fax: 612-863-3049
Mailing address:
  • Phone: 651-767-2039
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberR1612332
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: