PENNY JO WALDUM RN
NPI 1003279332
Registered Nurse in Superior, WI

Q: What is Penny Jo Waldum's NPI number?

The NPI number for Penny Jo Waldum is 1003279332. It was assigned to this individual provider in the NPPES registry on April 4, 2016.

Q: What is Penny Jo Waldum's specialty?

The primary specialty registered for this NPI is Registered Nurse with taxonomy code 163W00000X.

Q: When was this NPI record last updated?

The NPPES record for Penny Jo Waldum was last updated on January 30, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since April 04, 2016

2222 E 5TH ST, SUPERIOR, WI 54880(715) 392-1955(715) 392-1935 Get Directions Write a Review

NPPES record last updated: January 30, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Oct 18, 2021, Oct 15, 2021, Oct 2, 2020 (3 updates tracked since 2020).

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About Penny Jo Waldum Rn NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PENNY JO WALDUM RN (NPI 1003279332) is an individual registered nurse in Superior, Wisconsin, licensed in Wisconsin (174931-30) and active in the NPI registry since April 2016. She maintains a secondary practice location in Duluth.

NPPES Registry Identity

NPI1003279332

Entity TypeIndividualFemale

Primary Taxonomy163W00000X

Provider Legal NamePENNY JO WALDUMCredential: RN

Location Address2222 E 5TH STSuperior, WI 54880-3709

Mailing Address2222 E 5th StSuperior, WI 54880-3709 · (715) 392-1955 · Fax (715) 392-1935

Phone(715) 392-1955

Fax(715) 392-1935

Sole ProprietorNo

Enumeration DateApril 4, 2016

Last NPPES UpdateJanuary 30, 20243 updates tracked since enumeration

NPPES CertifiedJanuary 30, 2024

✔ NPI 1003279332 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyRegistered NurseNursing Service Providers

Taxonomy Code163W00000X

Licenses✔ Licensed in WI · 174931-30✔ Licensed in MN · 2043010

Definition

(1) A registered nurse is a person qualified by graduation from an accredited nursing school (depending upon schooling, a registered nurse may receive either a diploma from a hospital program, an associate degree in nursing (A.D.N.) or a Bachelor of Science degree in nursing (B.S.N.), who is licensed or certified by the state, and is practicing within the scope of that license or certification. R.N.'s assist patient in recovering and maintaining their physical or mental health. They assist physicians during treatments and examinations and administer medications. (2) A provider who is trained and educated in a formal nursing education program at an accredited school of nursing, passes a national certification examination, and is licensed by the state to practice nursing. The individual provides nursing services to patients or clients in areas such as health promotion, disease prevention, acute and chronic care and restoration and maintenance of health across the life span.

2222 E 5TH ST, Superior, WI 54880

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Secondary Practice Location 1

Location 14325 Grand AveDuluth, MN 55807-2730 · Phone (218) 722-1497 · Fax (218) 722-6239

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

HOLLY WOODHULL RN

Registered Nurse