Organization Active NPI

Mrs Sandman LLC

  • Certified Registered Nurse Anesthetist
  • Saint Cloud, MN
National Provider Identifier
1265912943
Registry record updated Aug 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
742 Issued in MN
Legal business name
MRS SANDMAN LLC
Practice address
1526 Northway Dr
Saint Cloud, MN 56303-1255
Phone
(612) 558-8108
NPI assigned
Aug 21, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Marissa Jo Qunell, CRNA, APRNNPI 1083917637
Title
Crna
Phone
(612) 558-8108

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse AnesthetistGroup: 193400000X SINGLE SPECIALTY GROUP 367500000X 742 MN Primary

Addresses

Primary practice location

1526 Northway Dr
Saint Cloud, MN 56303-1255

Mailing address

8095 Trail Haven Rd
Corcoran, MN 55340-8803
Phone (612) 558-8108

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1534809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534809600000",
    "number": "1265912943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8095 TRAIL HAVEN RD",
            "city": "CORCORAN",
            "state": "MN",
            "postal_code": "553408803",
            "telephone_number": "612-558-8108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1526 NORTHWAY DR",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563031255",
            "telephone_number": "612-558-8108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MRS SANDMAN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-21",
        "last_updated": "2018-08-21",
        "status": "A",
        "authorized_official_last_name": "QUNELL",
        "authorized_official_first_name": "MARISSA",
        "authorized_official_middle_name": "JO",
        "authorized_official_title_or_position": "CRNA",
        "authorized_official_telephone_number": "612-558-8108",
        "authorized_official_credential": "CRNA, APRN"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MN",
            "license": "742",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Cloud, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.