Individual
BROOKE MARIE WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BSN-RN, PHN
Contact information
Practice address
ALTRU CLINIC CROOKSTON, 400 S MINNESOTA STREET, CROOKSTON, MN 56716
(218) 281-9100
Mailing address
411 GOLF TER, CROOKSTON, MN 56716-1107
(218) 289-1057
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
2480220
MN
163WP2201X
Ambulatory Care Registered Nurse
R48895
ND
Other
Enumeration date
09/15/2023
Last updated
09/15/2023
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