Individual
AUDREY ANNE WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
601 W DUE WEST AVE, MADISON, TN 37115-4423
(615) 227-3000
Mailing address
2711 FOSTER AVE, NASHVILLE, TN 37210-5307
(573) 673-0000
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
76333
TN
207Q00000X
Family Medicine Physician
ME158286
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
115971600
—
FL
Enumeration date
04/07/2021
Last updated
02/20/2026
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