Individual
TRISHA RANEE SHAMP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C, PHD
Contact information
Practice address
3366 OAKDALE AVE N, SUITE 605, MINNEAPOLIS, MN 55422-2948
(763) 520-2940
(763) 520-2943
Mailing address
18300 TYLER ST NW, ELK RIVER, MN 55330-4529
(612) 801-1375
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
9508
MN
Other
Enumeration date
06/06/2007
Last updated
12/29/2008
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