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NPI Code Detail

MEDICARE: CHAUNTEL SPALJ

MEDICARE: CHAUNTEL SPALJ
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program
2367500000XCertified Registered Nurse Anesthetist2363MN

General Provider Information

NPI Number : 1376061408
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHAUNTEL SPALJ
Provider Business Mailing Address
First Line : 7161 FRANCE AVE S APT 413
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55435-4341
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6401 FRANCE AVE S
Second Line :
City : EDINA
State : MN
Zip : 55435-2199
Country : US
Telephone Number : 952-924-5000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/08/2017
Last Update Date : 09/25/2019

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Directions to “ CHAUNTEL SPALJ ” Practice Location

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