Individual
BENJAMIN WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3400 MEIJER DR, TOLEDO, OH 43617-1166
(419) 843-1370
Mailing address
525 METRO PL N STE 300, DUBLIN, OH 43017-5320
(855) 289-1722
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN.473174
OH
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
APRN.CNP.0037789
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2910854
—
OH
Enumeration date
08/24/2022
Last updated
06/05/2025
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