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Individual

DR. ELIZABETH KATE BLIXT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1900 CENTRACARE CIR, SUITE 2575, ST CLOUD, MN 56303-5000
(320) 229-4924
(320) 229-4971
Mailing address
1900 CENTRACARE CIR, SUITE 2575, ST CLOUD, MN 56303-5000
(320) 229-4924
(320) 229-4971

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
107024
MN
207N00000X
Dermatology Physician
Primary
56812
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
P01238261
RAILROAD MEDICARE
MN
Enumeration date
07/26/2012
Last updated
06/14/2016
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