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Individual

MELANIE IMKER WONG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1025 MARSH ST, MANKATO, MN 56001-4752
(507) 625-4031
Mailing address
20018 INDIAN LAKE RD, MANKATO, MN 56001-6617
(651) 325-7319

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
4704290170
MI
163W00000X
Registered Nurse
R-192262-4
MN
367500000X
Certified Registered Nurse Anesthetist
Primary
CRNA 1924
MN

Other

Enumeration date
02/05/2016
Last updated
09/05/2025
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