DR. ANDENUM AMOS WAQUONG DNP, PHN, FNP-C
NPI 1346083219
Nurse Practitioner in White Bear Lake, MN

Q: What is Andenum Waquong's NPI number?

The NPI number for Andenum Waquong is 1346083219. It was assigned to this individual provider in the NPPES registry on June 17, 2024.

Q: What is Andenum Waquong's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Q: When was this NPI record last updated?

The NPPES record for Andenum Waquong was last updated on June 30, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months 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 June 17, 2024

2730 COUNTY ROAD E E, WHITE BEAR LAKE, MN 55110(651) 777-6816 Get Directions Write a Review

NPPES record last updated: June 30, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jun 30, 2025, Aug 1, 2024, Jul 15, 2024 and 1 more (4 updates tracked since 2024).

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About Dr. Andenum Amos Waquong Dnp, Phn, Fnp-c NPPES

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

DR. ANDENUM AMOS WAQUONG DNP, PHN, FNP-C (NPI 1346083219) is an individual nurse practitioner in White Bear Lake, Minnesota, licensed in Minnesota (11769) and active in the NPI registry since June 2024.

NPPES Registry Identity

NPI1346083219

Entity TypeIndividualMale

Primary Taxonomy363L00000X

Provider Legal NameDR. ANDENUM AMOS WAQUONGCredential: DNP, PHN, FNP-C

Location Address2730 COUNTY ROAD E EWhite Bear Lake, MN 55110-4963

Mailing Address5210 Porchlight BayWoodbury, MN 55129-3700 · (706) 619-9010

Phone(651) 777-6816

Sole ProprietorNo

Enumeration DateJune 17, 2024

Last NPPES UpdateJune 30, 20254 updates tracked since enumeration

NPPES CertifiedJune 30, 2025

✔ NPI 1346083219 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

License✔ Licensed in MN · 11769

Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

Also ListedRegistered NurseTaxonomy 163W00000X · License 2310523 (MN), RN262014 (GA), 95283925 (CA)

Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X · License RN262014 (GA), 11769 (MN)

2730 COUNTY ROAD E E, White Bear Lake, MN 55110

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Other Providers at the Same Location NPPES 11

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

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