Individual
BRENDA L WAGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
11630 E 1300TH ST, CAMBRIDGE, IL 61238-9446
(309) 937-1919
Mailing address
11630 E 1300TH ST # 2, CAMBRIDGE, IL 61238-9446
(309) 937-1919
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209.014538
IL
Other
Enumeration date
08/16/2016
Last updated
05/10/2021
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