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Individual

MOLLY WAMBACH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
APRN-FNP

Contact information

Practice address
510 4TH ST S, FARGO, ND 58103-1914
(701) 476-7200
Mailing address
17061 50TH ST N, GEORGETOWN, MN 56546-9432

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R42008
ND
363LF0000X
Family Nurse Practitioner
Primary
R42008
ND

Other

Enumeration date
06/28/2021
Last updated
08/29/2022
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