Individual
MIRANDA NEUBAUER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
500 S MAPLE ST, WACONIA, MN 55387-1752
(952) 556-2600
(952) 556-2601
Mailing address
500 S MAPLE ST, WACONIA, MN 55387-1791
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
2219006
MN
363L00000X
Nurse Practitioner
7804
MN
363LF0000X
Family Nurse Practitioner
Primary
7804
MN
Other
Enumeration date
01/26/2020
Last updated
06/17/2024
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