Individual
MRS. JENNIFER HART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
100 STATE AVE, FARIBAULT, MN 55021-6337
(507) 334-3921
Mailing address
100 STATE AVE, FARIBAULT, MN 55021-6337
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
11126
MN
Other
Enumeration date
06/11/2012
Last updated
03/11/2021
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