Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207ND0101X | MOHS-Micrographic Surgeon | 61224 | MN |
N | 207ND0101X | MOHS-Micrographic Surgeon | MD454550 | PA |
NPI | 1003109059 |
---|---|
Provider Name | Dr. Amanda Joy Tschetter |
First Address | Edina, MN 55435-2532 |
Second Address | Edina, MN 55435-2532 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2011 |
Last Update Date | 06/04/2021 |