NPI Profile for SHANA L WAGNER in SHEBOYGAN FALLS, WI.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Family |
363LF0000X | 50 | Nurse Practitioner | |
Hospice and Palliative Medicine |
207QH0002X | 08 | Physician/Family Practice | |
Registered Nurse |
163W00000X |
| NPI Number | 1699072140 |
|
| Status | Active | |
| Credentials | MSN, FNP-BC | |
| Entity | Individual | |
| Enumeration date | 02/18/2011 | |
| Last updated | 01/03/2025 - More than a year ago | |
| Sole proprietor 1 | No | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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SHANA L WAGNER
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