Individual
MS. ANNALIESE O WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP, FNP-C
Contact information
Practice address
2500 OVERLOOK TER, MADISON, WI 53705-2254
(608) 280-7131
Mailing address
2500 OVERLOOK TER, MADISON, WI 53705-2254
(608) 280-7131
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
9291-33
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0254161
—
WI
Enumeration date
04/30/2019
Last updated
03/14/2023
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