Individual
MISS CRYSTAL ANN WAAGMEESTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
3559 SHADY LANE CIR, EAST GULL LAKE, MN 56401-7940
(218) 234-3101
Mailing address
3559 SHADY LANE CIR, EAST GULL LAKE, MN 56401-7940
(218) 234-3101
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
11309
MN
363AM0700X
Medical Physician Assistant
3918-23
WI
Other
Enumeration date
02/07/2011
Last updated
10/05/2016
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