| Trent William Hagstrom, | |
|
6500 Excelsior Blvd, St Louis Park, MN 55426-4702 | |
| (952) 993-5000 | |
| Not Available |
| Full Name | Trent William Hagstrom |
|---|---|
| Gender | Male |
| Speciality | Certified Registered Nurse Anesthetist (crna) |
| Experience | 3 Years |
| Location | 6500 Excelsior Blvd, St Louis Park, 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 |
|---|---|---|---|
| 1467175422 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 163W00000X | Registered Nurse | 2458690 (Minnesota) | Secondary |
| 367500000X | Nurse Anesthetist, Certified Registered | 2790 (Minnesota) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Firstlight Health System | Mora, MN | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Welia Health | 6709295496 | 43 |
| Entity Name | Park Nicollet Methodist Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1083622047 PECOS PAC ID: 7315840063 Enrollment ID: O20040129000853 |
| Entity Name | Welia Health |
|---|---|
| Entity Type | Part A Provider - Critical Access Hospital |
| Entity Identifiers | NPI Number: 1528031390 PECOS PAC ID: 6709295496 Enrollment ID: O20210722002959 |
| Entity Name | Welia Health |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1528031390 PECOS PAC ID: 6709295496 Enrollment ID: O20220125001227 |
| Mailing Address | Practice Location Address |
|---|---|
| Trent William Hagstrom, 1778 Jonquil Ln N, Plymouth, MN 55441-4021 Ph: (612) 501-6794 | Trent William Hagstrom, 6500 Excelsior Blvd, St Louis Park, MN 55426-4702 Ph: (952) 993-5000 |
Lindsey Marie Knapp, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 6500 Excelsior Blvd, St Louis Park, MN 55426 Phone: 952-993-5000 | |
Ms. Susan J Bermel, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 6500 Excelsior Blvd, Anesthesiology, St Louis Park, MN 55426 Phone: 952-993-5222 | |
Anne Katherine Hennes, APRN, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 6500 Excelsior Blvd, St Louis Park, MN 55426 Phone: 952-993-6016 | |
Alexis Rose Boll, Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 6500 Excelsior Blvd, St Louis Park, MN 55426 Phone: 952-993-6016 | |
Adrienne Backus, Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 6500 Excelsior Blvd, St Louis Park, MN 55426 Phone: 952-993-5000 | |
Frank A Jirik, Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 6500 Excelsior Blvd, St Louis Park, MN 55426 Phone: 952-993-5000 | |
Carie Voges, Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 6500 Excelsior Blvd, St Louis Park, MN 55426 Phone: 952-993-5000 |