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Individual

GAIL T. WAGNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
900 ILLINOIS AVE, STEVENS POINT, WI 54481-3114
(715) 346-5000
Mailing address
N8311 BACHELORS AVE, WILLARD, WI 54493-8774
(262) 844-6369

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1741
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1741
APNP WI STATE LIC
WI
01
74729
RN WI STATE LIC
WI
Enumeration date
11/01/2006
Last updated
09/21/2015
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