MS. NICOLE WAGNER APN NPI 1194968602

NPI Information

NPI: 1194968602
Provider Name: MS. NICOLE WAGNER, APN
Classification: Clinical Nurse Specialist - 364SA2200X
Entity Type: Individual

Specialization: Adult Health

PECOS Registration: Yes

Address:
431 W LIBERTY ST
WAUCONDA, IL
ZIP 60084
Phone: (847) 526-2151
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MS. Nicole Wagner, APN is an adult health clinical nurse specialist in Wauconda, IL with 23 years of experience. MS. Nicole Wagner, APN NPI is 1194968602. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: CLVLND CLINIC LERNER COLLEGE OF MED OF CASE WSTN RSV UNIVERSITY
Graduation Year:2001

The provider's business location address is:

431 W LIBERTY ST
WAUCONDA, IL
ZIP 60084-452
Phone: (847) 526-2151
Fax: (847) 526-2017

The NPI 1194968602 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 4/14/2009 and was last updated on 6/24/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family	209004749	ILLINOIS	No
2	364SA2200X	Clinical Nurse Specialist	Adult Health	209004749	ILLINOIS	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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