Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

DR. ANDENUM AMOS WAQUONG MD, DNP, PHN, FNP-C
NPI 1346083219
Military Hospital 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 Military Hospital with taxonomy code 286500000X.

Q: When was this NPI record last updated?

The NPPES record for Andenum Waquong was last updated on August 27, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 days 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: August 27, 2026. Verified against the NPPES registry weekly; last sync: August 30, 2026.

Record update history: Aug 27, 2026, Jun 30, 2025, Aug 1, 2024 and 2 more (5 updates tracked since 2024).

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

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

DR. ANDENUM AMOS WAQUONG MD, DNP, PHN, FNP-C (NPI 1346083219) is an individual military hospital provider in White Bear Lake, Minnesota and active in the NPI registry since June 2024. He maintains a secondary practice location in Apo.

NPPES Registry Identity

NPI1346083219

Entity TypeIndividualMale

Primary Taxonomy286500000X

Provider Legal NameDR. ANDENUM AMOS WAQUONGCredential: MD, 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 UpdateAugust 27, 20265 updates tracked since enumeration

NPPES CertifiedAugust 27, 2026

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

Specialties & Licenses 4

★ Primary SpecialtyMilitary HospitalHospitals

Taxonomy Code286500000X

Definition

A health care facility operated by the Department of Defense.

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

Also ListedNurse PractitionerTaxonomy 363L00000X · License 11769 (MN)

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

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

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Secondary Practice Location 1

Location 1PSC 1300, 452 MED DETAPO, AA 34042 · Phone (786) 684-4724

Other Providers at the Same Location NPPES 12

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

ROGER K KOOPMAN PA

Physician Assistant