Gregory Gill

Individual provider Active NPI Certified Registered Nurse Anesthetist · Granite Falls, MN

NPI 1174593149 · NPPES record last updated Jul 16, 2007

Key facts

NPI
1174593149
Entity type
Individual (NPI type 1)
Primary specialty
Certified Registered Nurse Anesthetist 367500000X
License
R1120361 (MN)
Practice address
345 10TH Ave
Granite Falls, MN 56241-1442
Phone
(320) 564-3111
Fax
(320) 564-2329
NPI assigned
Jan 24, 2006
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
R1120361MNMDCertified Registered Nurse Anesthetist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X R1120361 MN Yes

Addresses

Primary practice location

345 10TH Ave
Granite Falls, MN 56241-1442

Mailing address

345 10TH Ave
Granite Falls, MN 56241-1442
Phone (320) 564-3111

Other providers in Granite Falls, MN

All providers in Granite Falls, MN · Certified Registered Nurse Anesthetist in Minnesota

Sources for this page

Verify at the official NPI Registry.