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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

DR. ANDENUM AMOS WAQUONG, DNP, PHN, FNP-C

Active

DR. ANDENUM AMOS WAQUONG, DNP, PHN, FNP-C is a Nurse Practitioner healthcare provider located in WHITE BEAR LAKE, Minnesota. NPI 1346083219 is currently active in the NPPES registry. Verify at CMS.

Nurse Practitioner · WHITE BEAR LAKE, MN

Registration Details

NPI Number
1346083219
Provider Type
Individual
Gender
Male
NPI Issued
Jun 17, 2024 (2.1310173346121 yrs)
Last Updated
Jun 30, 2025
Licenses
2310523 (MN)
RN262014 (GA)
95283925 (CA)
RN262014 (GA)
11769 (MN)

Practice Information

Address
2730 COUNTY ROAD E E
WHITE BEAR LAKE, MN, 551104963
Browse MN providers · Browse ZIP 55110
Phone
6517776816
Primary Specialty
Nurse Practitioner
363L00000X
Additional Specialty
Registered Nurse
Additional Specialty
Registered Nurse
Additional Specialty
Family Nurse Practitioner
Additional Specialty
Family Nurse Practitioner

Other Nurse Practitioner Providers in WHITE BEAR LAKE, MN

Name Credential NPI
SHIRLEY LEE BEBENSEE NP 1447225164
MR. PATRICK G SPENCER FNP-C 1407949530
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.