Individual
NANCY MICHELE WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
2105 112TH AVE NE STE 201, BELLEVUE, WA 98004-2945
(425) 968-5948
Mailing address
2105 112TH AVE NE STE 201, BELLEVUE, WA 98004-2945
(425) 968-5948
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
121853
CT
163W00000X
Registered Nurse
RN60657515
WA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AP60677444
WA
Other
Enumeration date
05/03/2016
Last updated
10/17/2019
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