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Individual

AMANDA NIEMANN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
2024 S 6TH ST, BRAINERD, MN 56401-4529
(218) 828-7100
Mailing address
523 N 3RD ST, BRAINERD, MN 56401-3054
(218) 829-2861
(218) 828-3103

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
11528
MN

Other

Enumeration date
04/14/2014
Last updated
01/08/2016
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