Individual provider · NPI-1

Pam J. Waage, CPNP

Nurse Practitioner, Pediatrics · Saint Cloud, MN

NPI number1487857249
StatusActive
Last updated in NPPESJul 8, 2007

Details

NPI
1487857249
Entity type
Individual (NPI-1)
Name
Pam J. Waage
Credential
CPNP
Sex
Female
Sole proprietor
No
Enumeration date
Jun 8, 2007
Last updated
Jul 8, 2007

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363LP0200X Nurse Practitioner, PediatricsR1041631MNYes

Practice location

1245 15th St N
Saint Cloud, MN 56303-1802

Phone 320-253-5220 · Fax 320-203-2414

Mailing address

6997 47th Ave Se
Saint Cloud, MN 56304-9583

Phone 320-529-0051

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