Individual provider · Type 1 NPI
Brooke Marie Wagner, BSN-RN, PHN
Community Health Registered Nurse · Crookston, MN
NPI number
1134907710
Active
Practice location
Altru Clinic Crookston, 400 S Minnesota Street
Crookston, MN 56716
Mailing address
411 Golf Ter
Crookston, MN 56716-1107
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Community Health Registered Nurse Primary | 163WC1500X | 2480220 (MN) |
| Ambulatory Care Registered Nurse | 163WP2201X | R48895 (ND) |
Community Health Registered Nurse: Definition to come...
About NPI 1134907710
Brooke Marie Wagner, BSN-RN, PHN's National Provider Identifier is 1134907710, issued on Sep 15, 2023. The primary taxonomy on file is Community Health Registered Nurse (163WC1500X), and the practice location is in Crookston, MN. The record was last updated on Sep 15, 2023.