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NPI Code Detail

MEDICARE: CRAIG ROBERT HALL CRNA

MEDICARE:   CRAIG ROBERT HALL  CRNA
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
1367500000XCertified Registered Nurse AnesthetistR-119052-4MN

General Provider Information

NPI Number : 1992755268
Entity Type Code : Individual
Provider Name (Legal Business Name) : CRAIG ROBERT HALL CRNA
Provider Business Mailing Address
First Line : 1628 CANNON VALLEY DR
Second Line :
City : NORTHFIELD
State : MN
Zip : 55057-3362
Country : US
Telephone Number : 507-663-1176
Fax Number :
Provider Business Practice Location Address
First Line : 2000 NORTH AVE
Second Line :
City : NORTHFIELD
State : MN
Zip : 55057-1498
Country : US
Telephone Number : 507-646-1000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/10/2006
Last Update Date : 07/08/2007

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Directions to “ CRAIG ROBERT HALL CRNA” Practice Location

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