Individual
ROLEEN RUTH WALGENBACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RNP
Contact information
Practice address
425 7TH ST NW, CASS LAKE, MN 56633-3360
(218) 335-3200
Mailing address
425 7TH ST NW, CASS LAKE, MN 56633-3360
(218) 335-3200
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
53270
WI
207Q00000X
Family Medicine Physician
Primary
R116915-7
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
58G75WA
BCBS
MN
Enumeration date
08/23/2006
Last updated
07/09/2007
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