Individual
JAMIE GORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6515 BARRIE RD, EDINA, MN 55435-2363
(952) 920-5663
Mailing address
1025 CHERRY ST E, MAZEPPA, MN 55956-3014
(651) 214-1949
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
8674
MN
Other
Enumeration date
10/20/2021
Last updated
10/20/2021
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