OrganizationActive
Northern Lights Pediatric & Adolescent Medicine
NPI 1912069519 · Pediatric Adolescent Medicine Physician · Vadnais Heights, MN
Provider details
- NPI number
- 1912069519
- Entity type
- Organization
- Primary specialty
- Pediatric Adolescent Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Wendy Mccabe, Partner(651) 251-5280
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
3555 Willow Lake Blvd.
Suite 140
Vadnais Heights, MN 55110-4462
Phone: (651) 251-5280
Fax: (651) 251-5282
Approximate (ZIP-level) locationGet directions
Mailing address
3555 Willow Lake Blvd.
Vadnais Heights, MN 55110-4462
Registry dates
- Enumerated
- 2006-12-14
- Last updated
- 2009-05-20
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.