Individual
AMY R EASTENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
6500 EXCELSIOR BLVD, ST LOUIS PARK, MN 55426-4702
(952) 993-1000
Mailing address
PO BOX 9104, MINNEAPOLIS, MN 55480-9104
(952) 993-1000
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
38161
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
247821800
—
MN
Enumeration date
04/03/2006
Last updated
07/21/2022
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