Individual
WENDY MARION NELMS MCCABE
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3585 LEXINGTON AVE N, SUITE 350, SHOREVIEW, MN 55126-8064
(651) 484-3942
(651) 787-0519
Mailing address
3585 LEXINGTON AVE N, SUITE 350, SHOREVIEW, MN 55126-8064
(651) 251-5280
(651) 251-5282
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
41678
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1201039
MEDICA
MN
01
—
1201042
MEDICA
MN
05
—
299L4MC
—
MN
01
—
CP9091026080
PREFERRED ONE
MN
Enumeration date
09/07/2005
Last updated
07/09/2007
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