Provider Demographics
NPI:1831145358
Name:BAYNE, MILTON L (CRNA)
Entity type:Individual
Prefix:
First Name:MILTON
Middle Name:L
Last Name:BAYNE
Suffix:
Gender:M
Credentials:CRNA
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Mailing Address - Street 1:P.O. BOX 209036
Mailing Address - Street 2:SHRINERS HOSPITALS FOR CHILDREN TWIN CITIES
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75320-9036
Mailing Address - Country:US
Mailing Address - Phone:813-281-8478
Mailing Address - Fax:813-281-8113
Practice Address - Street 1:2025 E RIVER PARKWAY
Practice Address - Street 2:SHRINERS HOSPITALS FOR CHILDREN TWIN CITIES
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55414-3604
Practice Address - Country:US
Practice Address - Phone:612-596-6187
Practice Address - Fax:612-339-7634
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2011-04-04
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Provider Licenses
StateLicense IDTaxonomies
MN049953367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN101221500Medicaid
MNP00203113OtherMEDICARE RAILROAD
MN16F46BAOtherBLUE CROSS BLUE SHIELD
MN430005829Medicare Oscar/Certification
MN16F46BAOtherBLUE CROSS BLUE SHIELD