Individual provider · Type 1 NPI
Michael David Wagner, MS, RN, CNP, PMHNPBC
Psychiatric/Mental Health Nurse Practitioner · Clarksburg, MD
NPI number
1699384958
Active
Practice location
13719 Lapwing Way
Clarksburg, MD 20871-3401
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Registered Nurse | 163W00000X | 191995-4 (MN) |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 7558 (MN) |
| Psychiatric/Mental Health Nurse Practitioner Primary | 363LP0808X | R247240 (MD) |
Psychiatric/Mental Health Nurse Practitioner: Definition to come...
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About NPI 1699384958
Michael David Wagner, MS, RN, CNP, PMHNPBC's National Provider Identifier is 1699384958, issued on Jul 23, 2020. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Clarksburg, MD. The record was last updated on Aug 25, 2025.