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Individual
PENELOPE ANDREA WAGNER
Active
Individual
PENELOPE ANDREA WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
163WG0600X
Gerontology Registered Nurse
RN-75898
CO
363LA2200X
Adult Health Nurse Practitioner
Primary
APN.0005547-NP
CO
363LG0600X
Gerontology Nurse Practitioner
5547
CO
Other
Enumeration date
01/16/2008
Last updated
07/16/2026
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