Healthcare Provider Details

I. General information

NPI: 1558337733
Provider Name (Legal Business Name): LINDA KAY RITTER CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/27/2006
Last Update Date: 10/02/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 E 28TH ST
MINNEAPOLIS MN
55407-3723
US

IV. Provider business mailing address

8990 SPRINGBROOK DR NW
COON RAPIDS MN
55433-5884
US

V. Phone/Fax

Practice location:
  • Phone: 865-342-8900
  • Fax: 865-691-0843
Mailing address:
  • Phone: 763-398-0099
  • Fax: 763-398-0124

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number1005
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: