Individual
JACOB LEON WALGRAVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
1 VETERANS DR, MINNEAPOLIS, MN 55417-2309
(612) 467-2111
Mailing address
PO BOX 126, WYOMING, MN 55092-0126
(651) 955-5560
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
2457452
MN
Other
Enumeration date
07/18/2017
Last updated
07/18/2017
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