Provider Demographics
NPI:1336199421
Name:BASNEY, COLLEEN ANN (CRNA)
Entity Type:Individual
Prefix:
First Name:COLLEEN
Middle Name:ANN
Last Name:BASNEY
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:COLLEEN
Other - Middle Name:CRNA
Other - Last Name:BASNEY NORRIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:COLLEEN BASNEY
Mailing Address - Street 2:495 CRETIN AVE. SO.
Mailing Address - City:ST. PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55116
Mailing Address - Country:US
Mailing Address - Phone:612-270-9458
Mailing Address - Fax:
Practice Address - Street 1:METROPOLITAN ANESTHESIA NETWORK LLP
Practice Address - Street 2:333 SMITH AVE. N
Practice Address - City:ST. PAUL
Practice Address - State:MN
Practice Address - Zip Code:55102-2344
Practice Address - Country:US
Practice Address - Phone:763-450-3986
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2019-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI83750367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered