Provider Demographics
NPI:1245396183
Name:HELLER, MARY C (CRNA)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:C
Last Name:HELLER
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Gender:F
Credentials:CRNA
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Mailing Address - Street 1:2910 CENTRE POINTE DRIVE
Mailing Address - Street 2:35 121A CHILDRENS HEALTH CARE
Mailing Address - City:ROSEVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55113
Mailing Address - Country:US
Mailing Address - Phone:651-855-2109
Mailing Address - Fax:651-855-2310
Practice Address - Street 1:2525 CHICAGO AVE S
Practice Address - Street 2:CHILDRENS HOSPITALS AND CLINICS OF MINNESOTA
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55404
Practice Address - Country:US
Practice Address - Phone:612-813-6273
Practice Address - Fax:612-813-7380
Is Sole Proprietor?:No
Enumeration Date:2006-12-28
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
MNR1071096367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered