Individual
MRS. JENNILEE S AMOAPIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
8100 NORTHLAND DR, BLOOMINGTON, MN 55431-4800
(952) 831-8742
(952) 806-5512
Mailing address
8170 33RD AVE S # MS 21110Q, BLOOMINGTON, MN 55425-4516
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10978
MN
390200000X
Student in an Organized Health Care Education/Training Program
1589
MN
Other
Enumeration date
08/04/2011
Last updated
03/11/2021
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