Individual
WANDA WIRTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4801 VETERANS DR, SAINT CLOUD, MN 56303-2015
(320) 252-1670
Mailing address
4129 CENTER ST, SAINT CLOUD, MN 56303-0349
(320) 253-0429
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
F02191068
MN
363LF0000X
Family Nurse Practitioner
F02191068
MN
Other
Enumeration date
07/29/2019
Last updated
04/17/2025
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