Individual provider · Type 1 NPI

Samantha Elizabeth Wagner, APRN

Nurse Practitioner · Rockford, IL

NPI number 1538631114 Active

Practice location

7180 Spring Brook Rd
Rockford, IL 61114-6700

Mailing address

PO Box 78866
Milwaukee, WI 53278-8866

Other practice locations

  • 209 9th St, Rockford, IL 61104-2235 · (779) 696-2750

Specialties and licenses

TaxonomyCodeLicense
Nurse Practitioner Primary 363L00000X209-018557 (IL)

Nurse Practitioner: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance wit…

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About NPI 1538631114

Samantha Elizabeth Wagner, APRN's National Provider Identifier is 1538631114, issued on Dec 20, 2018. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Rockford, IL. The record was last updated on May 20, 2024.