Individual
MRS. AMANDA JUNE INAS MIKHAEIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
14241 GRAND OAKS DR, BAXTER, MN 56425-8749
(218) 316-3101
Mailing address
1020 4TH ST NE APT 2, STAPLES, MN 56479-3352
(218) 296-2639
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
6720
MN
Other
Enumeration date
07/18/2019
Last updated
07/18/2019
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