Individual
DIANA THYSSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
9680 TAMARACK RD STE 100, WOODBURY, MN 55125
(651) 738-9001
Mailing address
9680 TAMARACK RD STE 100, WOODBURY, MN 55125-2623
(651) 738-9001
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
62995
MN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/22/2015
Last updated
07/18/2018
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