Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 30 days.
LEE ANN HERTZOG DONOVAN CPNP
NPI 1376516831
Registered Nurse - Pediatrics in Wayzata, MN
Active since February 07, 2006
250 N CENTRAL AVE, #101, WAYZATA, MN 55391(952) 473-0211(952) 473-7908 Get Directions Write a Review
About Lee Ann Hertzog Donovan Cpnp NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
LEE ANN HERTZOG DONOVAN CPNP (NPI 1376516831) is an individual pediatrics provider in Wayzata, Minnesota, licensed in Minnesota (R1497120) and active in the NPI registry since February 2006.
NPPES Registry Identity
NPI1376516831
Entity TypeIndividualFemale
Primary Taxonomy163WP0200X
Provider Legal NameLEE ANN HERTZOG DONOVANCredential: CPNP
Location Address250 N CENTRAL AVE, #101Wayzata, MN 55391
Mailing Address250 N Central Ave, #101Wayzata, MN 55391 · (952) 473-0211 · Fax (952) 473-7908
Phone(952) 473-0211
Fax(952) 473-7908
Sole ProprietorNo
Enumeration DateFebruary 7, 2006
Last NPPES UpdateJuly 13, 2026
✔ NPI 1376516831 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses
★ Primary SpecialtyRegistered Nurse · PediatricsNursing Service Providers
Taxonomy Code163WP0200X
License✔ Licensed in MN · R1497120
250 N CENTRAL AVE, Wayzata, MN 55391
Other Names 1
Former Name (1)Lee Ann Hertzog
Other Providers at the Same Location NPPES 4
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1376516831, enumerated as an "individual" on February 07, 2006.
The provider is located at 250 N CENTRAL AVE #101 WAYZATA, MN 55391 and the phone number is (952) 473-0211.
Registered Nurse with taxonomy code 163WP0200X and a focus in Pediatrics.
