Individual
KATHY MAE WIEBUSCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
500 W MAIN ST STE 11, ANOKA, MN 55303-2000
(763) 753-8658
(763) 753-4314
Mailing address
14216 SILVEROD ST NW, ANDOVER, MN 55304-3268
(763) 772-5764
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
R1224649
MN
Other
Enumeration date
12/30/2022
Last updated
12/30/2022
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