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Individual

TIFFANEY JO HAMMER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
11850 BLACKFOOT NW, SUITE 100, COON RAPIDS, MN 55433-2569
(763) 721-2100
(763) 721-2190
Mailing address
2550 UNIVERSITY AVE W STE 110N, SAINT PAUL, MN 55114-2001
(651) 602-5309
(651) 222-6786

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
10460
MN
363AS0400X
Surgical Physician Assistant
Primary
10460
MN

Other

Enumeration date
11/12/2008
Last updated
11/29/2017
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