Most Relevant Information
Provider Data
| NPI Number: | 1003833187 |
| Provider Name: | MONA M SELIM CRNA |
| Entity Type: | Individual |
| Taxonomy Code: | 163W00000X |
| Specialty: | Registered Nurse |
| License Number: | R1093171 |
Most Important Dates
| Enumeration Date: | 07/16/2006 |
| Last Updated: | 07/08/2007 |
Provider Practice Location
6465 WAYZATA BLVD
STE 315
ST LOUIS PARK
MN
554261728
Practice Location Phone/Fax
| Phone: | 9529937169 |
| Fax: | 9529930300 |
Provider Mailing Location
6465 WAYZATA BLVD
STE 315
ST LOUIS PARK
MN
554261728
Provider Mailing Phone/Fax
| Phone: | 9529937169 |
| Fax: | 9529930300 |