Individual
MRS. CHELSEA WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSN, FNP-BC, RN
Contact information
Practice address
2002 S 11TH ST, NILES, MI 49120-4074
(269) 687-0200
Mailing address
2002 S 11TH ST, NILES, MI 49120-4074
(269) 687-0200
(269) 684-0199
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
47404318133
MI
Other
Enumeration date
12/05/2022
Last updated
08/15/2023
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