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Individual

KIMBERLY JO HAUCH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
1301 33RD ST S, SAINT CLOUD, MN 56301-9668
(320) 251-8181
(320) 251-6942
Mailing address
251 COUNTY ROAD 120, SAINT CLOUD, MN 56303-4872
(320) 251-8181
(320) 251-6942

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
9021
MN
363AM0700X
Medical Physician Assistant
9021
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
731174500
MN
Enumeration date
11/10/2006
Last updated
11/15/2022
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