Wrage, Darla J

Wrage, Darla J is an individual health care provider with primary practice located at 1421 Premier Dr , Mankato MN 56001-6076. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Wrage, Darla J can be contacted via phone (507) 625-1811.

Contact Information

Primary practice address
1421 Premier Dr Mankato MN 56001-6076
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 44552 Wisconsin
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 40206 Minnesota

Profile Details

NPI number 1225032980
LBN Legal business name Wrage, Darla J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 10th, 2005
Last updated Jul 23rd, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1225032980 NPPES
Wisconsin MEDICAID 34266800

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