Individual provider · Type 1 NPI
Jill Irene Wagoner, NP
Adult Health Nurse Practitioner · La Crosse, WI
NPI number
1942928114
Active
Practice location
1900 South Ave
La Crosse, WI 54601-5467
Mailing address
1836 South Ave
La Crosse, WI 54601-5429
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Acute Care Nurse Practitioner | 363LA2100X | 11818-33 (WI) |
| Adult Health Nurse Practitioner Primary | 363LA2200X | 11818-33 (WI) |
Adult Health Nurse Practitioner: Definition to come...
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About NPI 1942928114
Jill Irene Wagoner, NP's National Provider Identifier is 1942928114, issued on Aug 15, 2022. The primary taxonomy on file is Adult Health Nurse Practitioner (363LA2200X), and the practice location is in La Crosse, WI. The record was last updated on Sep 15, 2026.