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Minnesota uniform credentialing application

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The document is the Minnesota Uniform Credentialing Application for initial credentialing of physicians, dentists, and allied health professionals. It outlines the necessary personal information, credentialing contact details, educational background, employment history, specialty certifications, and required documentation for applicants. The application includes sections for professional references, disclosure questions regarding past disciplinary actions or legal issues, and attestation of the accuracy of the provided information. Additionally, it emphasizes the importance of submitting complete and accurate data to facilitate the credentialing process.

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