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General NPI Number Information
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NPI Number | 1760410963
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Entity Type | Individual
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Provider Name | COLEEN SUE HELBERG CRNA
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Gender | Female
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Dates
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Enumeration Date | 06/28/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1455 SAINT FRANCIS AVE
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City | SHAKOPEE
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State | MN
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Zip | 55379-3374
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Country | US
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Telephone | 952-403-2305
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Fax |
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Provider Business Mailing Address
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Address Line | 3191 LAKE BLUFF CIR NW
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City | PRIOR LAKE
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State | MN
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Zip | 55372-1661
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Country | US
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Telephone | 952-226-3191
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | R 125341-6
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License Number State | MN
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