Mary C Wiczek, APRN,CNP
Nurse Practitioner, Family in Saint Cloud, MN. Individual provider (NPI-1).
NPI number1962003277
StatusActive
Last updated in NPPESJul 9, 2021
Details
- NPI
- 1962003277
- Entity type
- Individual (NPI-1)
- Name
- Mary C Wiczek
- Credential
- APRN,CNP
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Nov 3, 2020
- Certification date
- Jul 9, 2021
- Last updated
- Jul 9, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | 7722 | MN | Yes |
Practice location
2420 W Division StSaint Cloud, MN 56301-3926
Phone 866-389-2727
Mailing address
2420 W Division StSaint Cloud, MN 56301-3926
Phone 866-389-2727
Other practice locations
1027 Washington Ave
Detroit Lakes, MN 56501-3409
Detroit Lakes, MN 56501-3409
Phone 218-847-5611
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