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Individual

MRS. AMY CORINNE DEARKING

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1528 NORTHWAY DR, SAINT CLOUD, MN 56303-1255
(320) 252-0233
(320) 252-1421
Mailing address
1528 NORTHWAY DR, SAINT CLOUD, MN 56303-1255
(320) 252-0233
(320) 252-1421

Taxonomy

Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
51891
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
ENROLLED
IA
05
ENROLLED
MN
01
P01173520
RAILRAOD MEDICARE
MN
Enumeration date
07/11/2008
Last updated
12/28/2021
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