Healthcare Provider Details

I. General information

NPI: 1750390258
Provider Name (Legal Business Name): EUISHIN JUNG CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: EUISHIN MURPHY CRNA

II. Dates (important events)

Enumeration Date: 08/05/2006
Last Update Date: 12/17/2021
Certification Date: 12/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 1ST STREET SW
ROCHESTER MN
55905
US

IV. Provider business mailing address

200 1ST STREET SW
ROCHESTER MN
55905
US

V. Phone/Fax

Practice location:
  • Phone: 507-284-2511
  • Fax:
Mailing address:
  • Phone: 507-284-2511
  • Fax: 570-768-3911

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN582184
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number244780-7
License Number StateMN
# 3
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number2067
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: