Individual
AMY WOGEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, CNP
Contact information
Practice address
2925 CHICAGO AVE, MINNEAPOLIS, MN 55407-1321
(651) 262-7633
(612) 262-0156
Mailing address
2925 CHICAGO AVE, MINNEAPOLIS, MN 55407-1321
(612) 262-9000
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
341
MN
363LG0600X
Gerontology Nurse Practitioner
359780-23
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
240749300
—
MN
Enumeration date
10/10/2005
Last updated
04/10/2025
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