Unknown Individual – Certified Registered Nurse Anesthetist, NPI 1184692709

Unknown Individual is a healthcare provider. based in Bloomington, Minnesota. specializing in Certified Registered Nurse Anesthetist. They hold a License No. R0691765 (MN). The NPI Number for Unknown Individual is 1184692709

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1184692709
Phone
(952) 883-7961
Address
8100 34TH AVE S
Deactivation Date
20 September 2023
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • 34th Avenue South, Bloomington, Hennepin County, Minnesota, 55425, United States

    21110Q

    BLOOMINGTON, MN 554251672

    Phone: (952) 883-7961

    Fax: (952) 883-5395

    Type: Mailing

  • Regions Hospital, 640, Jackson Street, Saint Paul, Ramsey County, Minnesota, 55101, United States

    MAIL STOP 11503P

    ST PAUL, MN 551012502

    Phone: (651) 254-3456

    Fax: (651) 254-3048

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

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Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 55425)

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Reviews

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Frequently asked questions

How is Unknown Individual identified in CMS data?
CMS-hosted NPPES data lists Unknown Individual with NPI 1184692709.
Why is Unknown Individual marked inactive in the NPI directory?
The public NPI listing for Unknown Individual is not currently active; confirm directly with the practice or licensing boards.
What is Unknown Individual's primary classification?
Certified Registered Nurse Anesthetist is the headline specialty for Unknown Individual here. Clinical services aligned with this taxonomy classification.
Does Unknown Individual list a practice location?
Patients near Bloomington, Minnesota may find Unknown Individual in results; validate coverage separately.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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