SAMUEL PATRICK FAUNILLAN OTIS

ST LOUIS PARK, MN
NPI1619452075
Former NameSAMUEL FAUNILLAN
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy367500000X Nurse Anesthetist, Certified Registered
(Licence: MN  2287)
Enumeration Date2018-10-01
Last Update Date2025-11-24
Business Address
SAMUEL PATRICK FAUNILLAN OTIS CRNA
6500 EXCELSIOR BLVD
ST LOUIS PARK, MN 55426-4702
Phone number: 952-993-5000
Mailing Address
SAMUEL PATRICK FAUNILLAN OTIS CRNA
8170 33RD AVE S # MS 21110Q
BLOOMINGTON, MN 55425-4516
Phone number:
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