Individual
GRETCHEN WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
W6981 PARKVIEW DR, GREENVILLE, WI 54942-8034
(920) 882-2400
Mailing address
W6981 PARKVIEW DR, GREENVILLE, WI 54942-8034
(920) 882-2400
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
67986-20
WI
207QA0401X
Addiction Medicine (Family Medicine) Physician
67986-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100071647
—
WI
Enumeration date
03/22/2016
Last updated
10/16/2025
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