Individual
KATIE MCCLELLAN WIGDAHL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
10900 WAYZATA BLVD STE 215, MINNETONKA, MN 55305-5505
(952) 500-0350
Mailing address
4848 COUNTY ROAD 101, MINNETONKA, MN 55345-2635
(952) 401-3830
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1209
MN
363LF0000X
Family Nurse Practitioner
10512
MN
Other
Enumeration date
10/03/2008
Last updated
01/30/2022
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