Provider Demographics
NPI:1487769071
Name:WACHDORF, CECILIA MARIE (CNM)
Entity type:Individual
Prefix:DR
First Name:CECILIA
Middle Name:MARIE
Last Name:WACHDORF
Suffix:
Gender:F
Credentials:CNM
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Mailing Address - Street 1:1875 WOODWINDS DR
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:MN
Mailing Address - Zip Code:55125-2298
Mailing Address - Country:US
Mailing Address - Phone:651-232-6700
Mailing Address - Fax:651-232-6711
Practice Address - Street 1:1875 WOODWINDS DR
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:MN
Practice Address - Zip Code:55125-2298
Practice Address - Country:US
Practice Address - Phone:651-232-6700
Practice Address - Fax:651-232-6711
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2009-01-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MNR0881986367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife