Individual
RENEE ANNE GUNDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
1575 BEAM AVE, MAPLEWOOD, MN 55109-1126
(651) 232-7348
(651) 232-6665
Mailing address
3359 WILDWOOD TRL NW, PRIOR LAKE, MN 55372-3267
(612) 532-2414
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
9265
MN
Other
Enumeration date
08/24/2006
Last updated
07/08/2007
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