Individual
PAM J. WAAGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
1245 15TH ST N, SAINT CLOUD, MN 56303-1802
(320) 253-5220
(320) 203-2414
Mailing address
6997 47TH AVE SE, SAINT CLOUD, MN 56304-9583
(320) 529-0051
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
R1041631
MN
Other
Enumeration date
06/08/2007
Last updated
07/08/2007
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