Individual provider · Type 1 NPI
Tracie Denie Johnson-Wagner, PMHNP-BC
Psychiatric/Mental Health Nurse Practitioner · Phoenix, AZ
NPI number
1578064382
Active
Practice location
7330 N 16th St Ste C115
Phoenix, AZ 85020-8209
Fax (929) 596-7897
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | C-RXN.0002422-C-NP (CO) |
| Psychiatric/Mental Health Nurse Practitioner Primary | 363LP0808X | AP11024 (AZ) |
Psychiatric/Mental Health Nurse Practitioner: Definition to come...
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About NPI 1578064382
Tracie Denie Johnson-Wagner, PMHNP-BC's National Provider Identifier is 1578064382, issued on Feb 27, 2018. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Phoenix, AZ. The record was last updated on Feb 23, 2026.