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1629813704
KATHERINE MARIE WICKSTROM
OAKDALE, MN
NPI
1629813704
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Former Name
KATHERINE MARIE LEDDY
Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: MN F06242189)
Enumeration Date
2024-06-28
Last Update Date
2024-06-28
Business Address
KATHERINE MARIE WICKSTROM CNP
1099 HELMO AVE N STE 100
OAKDALE, MN 55128-6034
Phone number: 651-326-5300
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Mailing Address
KATHERINE MARIE WICKSTROM CNP
2828 HIGHWAY 88
ST ANTHONY, MN 55418-3243
Phone number: 605-254-3402
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