Individual
AMANDA L GILLETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
9680 TAMARACK RD STE 100, WOODBURY, MN 55125-2617
(651) 738-0470
(651) 738-8915
Mailing address
9680 TAMARACK ROAD, SUITE 100, WOODBURY, MN 55125-2617
(651) 738-0470
(651) 731-5031
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
61539
MN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/21/2014
Last updated
03/17/2018
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