OrganizationActive
Pediatric and Young Adult Medicine, PA
NPI 1710129812 · Primary Care Clinic/Center · Hudson, WI
Provider details
- NPI number
- 1710129812
- Entity type
- Organization
- Primary specialty
- Primary Care Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Terri Joseph, Clinic Administrator(651) 256-6706
- License
- 154 (MN)
Specialties & taxonomies
Ambulatory Health Care Facilities
Practice location
1610 Maxwell Dr
Suite 245
Hudson, WI 54016-8709
Phone: (651) 256-6706
Fax: (651) 256-6707
Approximate (ZIP-level) locationGet directions
Mailing address
1804 7th St W
Saint Paul, MN 55116-2300
Registry dates
- Enumerated
- 2009-04-03
- Last updated
- 2016-12-07
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.