Individual
JAMIE LAIRD WALDERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, PMHNP-BC
Contact information
Practice address
855 MANKATO AVE, WINONA, MN 55987-4868
(597) 457-4484
Mailing address
2504 HASS ST, LA CROSSE, WI 54601-7624
(608) 385-7504
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
10728
MN
Other
Enumeration date
08/30/2023
Last updated
08/30/2023
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