Healthcare Provider Details

I. General information

NPI: 1265511513
Provider Name (Legal Business Name): CATHERINE MARY ALWIN CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/06/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

ANESTHESIA DEPARTMENT 911 NORTHLAND DR.
PRINCETON MN
55371-2172
US

IV. Provider business mailing address

1294 JAMISON AVE NE
SAINT MICHAEL MN
55376-9361
US

V. Phone/Fax

Practice location:
  • Phone: 763-389-6384
  • Fax:
Mailing address:
  • Phone: 763-497-4649
  • Fax: 763-497-4985

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number41592
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: