Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Stephen C Wandersee, PA

Individual provider Physician Assistant · NPI 1407822554

Stephen C Wandersee, PA is a Physician Assistant in St Paul, Minnesota. Licensed in Minnesota. Registered with an NPI since 2006.

Licensed in
MN
In the registry since
2006
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

640 Jackson Street Mc 11102F
St Paul, MN 55101-2502
Phone: (651) 254-3456
Fax: (651) 254-5216
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 8866 (MN)

Record details

NPI number1407822554
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedFebruary 28, 2006
Last updated in NPPESMarch 24, 2015

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