Individual
MRS. DONNA MAE WAGNER
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
13705 W GREEN MEADOW LN, NEW BERLIN, WI 53151
(262) 786-6974
Mailing address
13635 W WILDFLOWER LN, NEW BERLIN, WI 53151
(414) 425-1592
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
—
WI
163WH0200X
Home Health Registered Nurse
Primary
—
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39858300
—
WI
Enumeration date
04/12/2006
Last updated
09/11/2025
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