Individual
EMILY LYNN WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BSN/RN, DNP/PMHNP
Contact information
Practice address
1836 SOUTH AVE, LA CROSSE, WI 54601-5429
(608) 782-7300
Mailing address
1836 SOUTH AVE, LA CROSSE, WI 54601-5429
(608) 782-7300
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
196882-30
WI
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
1741533
WI
Other
Enumeration date
01/23/2014
Last updated
02/20/2026
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