Individual
FAITH M WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
209 N 7TH ST, BISMARCK, ND 58501-4441
(701) 323-5590
Mailing address
PO BOX 5074, SIOUX FALLS, SD 57117-5074
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R24068
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1452844
—
ND
01
—
P00655489
RR MEDICARE
ND
Enumeration date
06/08/2006
Last updated
03/28/2025
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