Individual
DARLA J WRAGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1421 PREMIER DR, MANKATO, MN 56001-6076
(507) 625-1811
Mailing address
1230 E MAIN ST, PO BOX 8674, MANKATO, MN 56001-5066
(507) 625-1811
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
40206
MN
208000000X
Pediatrics Physician
44552
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
34266800
—
WI
Enumeration date
06/10/2005
Last updated
07/23/2020
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