Individual
VANESSA DEDE AMANOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3960 COON RAPIDS BLVD NW, SUITE 301, COON RAPIDS, MN 55433-2598
(651) 999-6800
(833) 905-2114
Mailing address
4053 NEVADA AVE N, NEW HOPE, MN 55427-1339
(651) 208-2568
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
09/01/2021
Last updated
10/09/2024
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