Individual
AMANDA PENICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
5320 HYLAND GREENS DR, BLOOMINGTON, MN 55437-3934
(952) 993-2400
(952) 993-2522
Mailing address
8265 OBRIAN AVE NE, OTSEGO, MN 55330-7413
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
14233
MN
363A00000X
Physician Assistant
—
—
Other
Enumeration date
09/20/2022
Last updated
01/10/2023
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