Individual
MARY IRENE WANGECHI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1415 LILAC DR N STE 190, GOLDEN VALLEY, MN 55422-4544
(763) 267-8701
Mailing address
1415 LILAC DR N STE 190, GOLDEN VALLEY, MN 55422-4544
(763) 267-8701
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
6895
MN
Other
Enumeration date
01/06/2021
Last updated
01/06/2021
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