Individual provider · Type 1 NPI
Ernestine A. Wagner, PA
Medical Physician Assistant · Stevens Point, WI
NPI number
1124072889
Active
Practice location
2417 Post Road, Building A
Stevens Point, WI 54481
Fax (715) 544-1212
Mailing address
2417 Post Road Building A
Stevens Point, WI 54481
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Medical Physician Assistant Primary | 363AM0700X | 1289-23 (WI) |
| Physician Assistant | 363A00000X | 978 (WV) |
| Medical Physician Assistant | 363AM0700X | 0110001577 (VA) |
Medical Physician Assistant: Definition to come...
About NPI 1124072889
Ernestine A. Wagner, PA's National Provider Identifier is 1124072889, issued on May 19, 2006. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Stevens Point, WI. The record was last updated on Jun 2, 2015.