Individual
AMY NICOLE WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
675 W WASHINGTON AVE, MADISON, WI 53703-2637
(608) 257-9700
(608) 250-2015
Mailing address
675 W WASHINGTON AVE, MADISON, WI 53703-2637
(608) 257-9700
(608) 250-2015
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
1704-023
WI
Other
Enumeration date
05/31/2006
Last updated
04/13/2017
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