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Individual

AMANDA LYNN FORTIER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
11850 BLACKFOOT ST NW STE 470, COON RAPIDS, MN 55433-2773
(651) 999-6800
(833) 905-2114
Mailing address
3001 METRO DR STE 460, BLOOMINGTON, MN 55425-1548
(651) 999-7022
(651) 999-6970

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
14693
MN

Other

Enumeration date
10/18/2023
Last updated
10/18/2023
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