Healthcare Provider Details

I. General information

NPI: 1518972298
Provider Name (Legal Business Name): REED EDWARD HILTNER CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/30/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 VETERANS DR
MINNEAPOLIS MN
55417-2309
US

IV. Provider business mailing address

5178 LONGVIEW DR
MOUNDS VIEW MN
55112-4811
US

V. Phone/Fax

Practice location:
  • Phone: 612-725-2000
  • Fax:
Mailing address:
  • Phone: 612-508-8789
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number147817-8
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: