Provider Demographics
NPI:1609691054
Name:COMFORT, SEAN (RN,SRNA)
Entity type:Individual
Prefix:
First Name:SEAN
Middle Name:
Last Name:COMFORT
Suffix:
Gender:M
Credentials:RN,SRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2617 ELMWOOD BLVD
Mailing Address - Street 2:
Mailing Address - City:WAUSAU
Mailing Address - State:WI
Mailing Address - Zip Code:54403-7016
Mailing Address - Country:US
Mailing Address - Phone:715-297-7626
Mailing Address - Fax:
Practice Address - Street 1:MINNEAPOLIS SCHOOL OF ANESTHESIA 700 EAST 7TH STREET
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55106
Practice Address - Country:US
Practice Address - Phone:715-297-7626
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-20
Last Update Date:2024-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program