Provider Demographics
NPI:1093365140
Name:LOKEN, WENDY ELLEN
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:ELLEN
Last Name:LOKEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11315 COUNTY ROAD 9
Mailing Address - Street 2:
Mailing Address - City:WANNASKA
Mailing Address - State:MN
Mailing Address - Zip Code:56761-9771
Mailing Address - Country:US
Mailing Address - Phone:218-425-3161
Mailing Address - Fax:
Practice Address - Street 1:11315 COUNTY ROAD 9
Practice Address - Street 2:
Practice Address - City:WANNASKA
Practice Address - State:MN
Practice Address - Zip Code:56761-9771
Practice Address - Country:US
Practice Address - Phone:218-425-3161
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-19
Last Update Date:2019-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)