Individual provider · Type 1 NPI
Justin Robert Wirth, DNP, APRN, PMHNP-BC
Psychiatric/Mental Health Nurse Practitioner · St. Cloud, MN
NPI number
1629687124
Active
Practice location
4801 Veterans Dr # 111
St. Cloud, MN 56303-2015
Mailing address
15953 47th St NW
Annandale, MN 55302-3902
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner Primary | 363LP0808X | 7559 (MN) |
Psychiatric/Mental Health Nurse Practitioner: Definition to come...
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About NPI 1629687124
Justin Robert Wirth, DNP, APRN, PMHNP-BC's National Provider Identifier is 1629687124, issued on Jul 30, 2020. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in St. Cloud, MN. The record was last updated on Jul 30, 2020.