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General NPI Number Information
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NPI Number | 1760588644
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Entity Type | Individual
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Provider Name | ERICA A PERRY CRNA
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Gender | Female
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Dates
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Enumeration Date | 09/16/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1575 BEAM AVE
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City | MAPLEWOOD
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State | MN
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Zip | 55109-1126
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Country | US
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Telephone | 651-735-0501
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Fax | 651-251-8050
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Provider Business Mailing Address
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Address Line | 875 HIGHLANDER TRL
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City | HUDSON
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State | WI
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Zip | 54016-7970
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Country | US
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Telephone |
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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 | R1375284
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License Number State | MN
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