Provider Demographics
NPI:1700856002
Name:PASCOE, CURTIS W (CRNA)
Entity Type:Individual
Prefix:
First Name:CURTIS
Middle Name:W
Last Name:PASCOE
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5200 FAIRVIEW BLVD
Mailing Address - Street 2:
Mailing Address - City:WYOMING
Mailing Address - State:MN
Mailing Address - Zip Code:55092-8013
Mailing Address - Country:US
Mailing Address - Phone:651-464-4611
Mailing Address - Fax:651-464-7627
Practice Address - Street 1:5200 FAIRVIEW BLVD
Practice Address - Street 2:
Practice Address - City:WYOMING
Practice Address - State:MN
Practice Address - Zip Code:55092-8013
Practice Address - Country:US
Practice Address - Phone:651-464-4611
Practice Address - Fax:651-464-7627
Is Sole Proprietor?:No
Enumeration Date:2006-01-26
Last Update Date:2012-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR0757735367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
965621012726OtherPREFERREDONE
MN38A55PAOtherBLUE CROSS
MN658742900Medicaid
WI43301000Medicaid
155995C737OtherUCARE
MN658742900Medicaid
WI43301000Medicaid