Individual
NINA E WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 805-8710
(414) 805-1101
Mailing address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 805-8710
(414) 805-1101
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
11521
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1457862435
—
WI
Enumeration date
10/18/2017
Last updated
11/20/2023
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