Individual
MS. ELIZABETH ANN WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGNP
Contact information
Practice address
1 BARNES JEWISH HOSPITAL PLZ, DIV IM CARDIOLOGY, SAINT LOUIS, MO 63110-1003
(314) 362-1291
(314) 362-4278
Mailing address
PO BOX 7412011, CHICAGO, IL 60674-2011
(314) 362-1291
(314) 362-4278
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
2016015963
MO
363LA2200X
Adult Health Nurse Practitioner
2016015963
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
420076130
—
MO
Enumeration date
06/01/2016
Last updated
04/17/2025
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