Individual
MRS. RENEE LINDA FUNK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
1406 6TH AVE N, ST CLOUD, MN 56303-1901
(320) 255-5656
(320) 654-2044
Mailing address
1406 6TH AVE N, SAINT CLOUD, MN 56303-1900
(320) 255-5657
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
9385
MN
Other
Enumeration date
02/27/2006
Last updated
07/08/2007
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