Yanqua Sumowuo Pewu, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

709356 Issued in MN

Practice address

4801 Veteran Drive
Saint Cloud, MN 56303

Phone

(320) 252-6380

NPI assigned

Feb 25, 2025

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1740441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740441600000",
    "number": "1295532661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11109 34TH ST NE",
            "city": "SAINT MICHAEL",
            "state": "MN",
            "postal_code": "553768457",
            "telephone_number": "612-270-4171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4801 VETERAN DRIVE",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "56303",
            "telephone_number": "320-252-6380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEWU",
        "first_name": "YANQUA",
        "middle_name": "SUMOWUO",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-02-25",
        "last_updated": "2025-02-25",
        "certification_date": "2025-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "MN",
            "license": "709356",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas Merlin Peterson, DDS
• George Petrangelo, LP
• Christine Petron
• Jodi Ann Petroski, PHARMD
• Richard Eldon Petzoldt, BS
• McKenzie Rose Pfeffer, PHARMD
• Kathleen M Pfleghaar, MD
• Sara Pflueger, LPCC
• Phuong Thuy Le Pham, DDS
• Ellyn Marie Phearman, PA

• All providers in Saint Cloud, MN
• Licensed Practical Nurse in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.