Individual
MS. DIANE JEANNETTE WAARVIK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSN, PNP
Contact information
Practice address
2414 PARK AVE, MINNEAPOLIS, MN 55404-3713
(612) 879-8730
Mailing address
5120 QUEEN AVE S, MINNEAPOLIS, MN 55410-2217
(612) 922-1846
(612) 928-1992
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
R063064-5
MN
Other
Enumeration date
06/26/2007
Last updated
07/08/2007
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