Andenum Amos Waquong, MD, DNP, PHN, FNP-C

Primary specialty

Military HospitalTaxonomy code 286500000X

Practice address

2730 County Road E E
White Bear Lake, MN 55110-4963

Phone

(651) 777-6816

NPI assigned

Jun 17, 2024

Last updated

Aug 27, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 7

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": "1718582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787788800000",
    "number": "1346083219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5210 PORCHLIGHT BAY",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551293700",
            "telephone_number": "706-619-9010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2730 COUNTY ROAD E E",
            "city": "WHITE BEAR LAKE",
            "state": "MN",
            "postal_code": "551104963",
            "telephone_number": "651-777-6816"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "PSC 1300",
            "address_2": "452 MED DET",
            "address_purpose": "LOCATION",
            "city": "APO",
            "state": "AA",
            "postal_code": "34042",
            "country_code": "US",
            "telephone_number": "786-684-4724",
            "country_name": "United States",
            "address_type": "MIL"
        }
    ],
    "basic": {
        "last_name": "WAQUONG",
        "first_name": "ANDENUM",
        "middle_name": "AMOS",
        "name_prefix": "Dr.",
        "credential": "MD, DNP, PHN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-06-17",
        "last_updated": "2026-08-27",
        "certification_date": "2026-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "286500000X",
            "taxonomy_group": "",
            "desc": "Military Hospital",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "11769",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "11769",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN262014",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95283925",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "RN262014",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MN",
            "license": "2310523",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Military Hospital in White Bear Lake, MN
• Providers in White Bear Lake, MN by specialty
• Military Hospital in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2026; 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.