Individual provider · Type 1 NPI
Nicole Wagner, APN
Adult Health Clinical Nurse Specialist · Wauconda, IL
NPI number
1194968602
Active
Practice location
431 W Liberty St
Wauconda, IL 60084-2452
Fax (847) 526-2017
Mailing address
PO Box 6037
Wauconda, IL 60084
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 209004749 (IL) |
| Adult Health Clinical Nurse Specialist Primary | 364SA2200X | 209004749 (IL) |
Adult Health Clinical Nurse Specialist: Definition to come...
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About NPI 1194968602
Nicole Wagner, APN's National Provider Identifier is 1194968602, issued on Apr 14, 2009. The primary taxonomy on file is Adult Health Clinical Nurse Specialist (364SA2200X), and the practice location is in Wauconda, IL. The record was last updated on Jun 24, 2019.