| Kyle Russell Wall, RN | |
|
701 Park Ave, Minneapolis, MN 55415-1623 | |
| (612) 873-5014 | |
| (612) 630-8270 |
| Full Name | Kyle Russell Wall |
|---|---|
| Gender | Male |
| Speciality | Certified Registered Nurse Anesthetist (crna) |
| Experience | 5 Years |
| Location | 701 Park Ave, Minneapolis, Minnesota |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013519867 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 163W00000X | Registered Nurse | 2188577 (Minnesota) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Ridgeview Medical Center | Waconia, MN | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Hennepin Healthcare System Inc | 4789684861 | 830 |
| Metropolitan Anesthesia Network Llp | 5698689123 | 497 |
| Entity Name | Metropolitan Anesthesia Network Llp |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1558314427 PECOS PAC ID: 5698689123 Enrollment ID: O20031118000579 |
| Entity Name | Hennepin Healthcare System Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1033138136 PECOS PAC ID: 4789684861 Enrollment ID: O20070207000467 |
| Mailing Address | Practice Location Address |
|---|---|
| Kyle Russell Wall, RN 8050 Lakebridge Ln, Victoria, MN 55386-3200 Ph: (612) 718-2989 | Kyle Russell Wall, RN 701 Park Ave, Minneapolis, MN 55415-1623 Ph: (612) 873-5014 |
Tiffanie J Woods, CPNP Registered Nurse Medicare: Not Enrolled in Medicare Practice Location: 2530 Chicago Ave, Minneapolis, MN 55404 Phone: 612-874-1292 | |
Tiffany Woynilko, RN Registered Nurse Medicare: Not Enrolled in Medicare Practice Location: 801 Park Ave, Minneapolis, MN 55404 Phone: 612-343-3265 Fax: 612-343-3267 | |
Rachel Foss, RN Registered Nurse Medicare: Not Enrolled in Medicare Practice Location: 801 Park Ave, Minneapolis, MN 55404 Phone: 612-343-3265 Fax: 612-343-3267 | |
Amanda Carter, RN Registered Nurse Medicare: Not Enrolled in Medicare Practice Location: 1099 10th Ave Se, Minneapolis, MN 55414 Phone: 612-767-6272 | |
Andrew Richard Erickson, CRNA Registered Nurse Medicare: Accepting Medicare Assignments Practice Location: 800 E 28th St, Minneapolis, MN 55407 Phone: 612-863-4000 | |
Tessa Somermeyer, Registered Nurse Medicare: Accepting Medicare Assignments Practice Location: 909 Fulton St Se, Minneapolis, MN 55455 Phone: 612-625-4680 | |
Kylie Marie Jackson, RN Registered Nurse Medicare: Not Enrolled in Medicare Practice Location: 715 S 8th St, Minneapolis, MN 55404 Phone: 612-873-6963 |