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Minnesota uniform credentialing application

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The document is the Minnesota Uniform Credentialing Application for initial credentialing of healthcare professionals, including physicians, dentists, and allied health professionals. It outlines the required personal information, credentialing contact details, educational background, employment history, hospital affiliations, specialty certifications, and necessary documentation to be submitted. The application includes a checklist of required documents and disclosure questions regarding professional conduct and licensure status. It emphasizes the importance of accuracy in the information provided and includes sections for attestation and authorization for information release.

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