Healthcare Provider Details

I. General information

NPI: 1720982978
Provider Name (Legal Business Name): EMILY ANN NAGEL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2026
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

475 CHIPPEWA MALL DR
CHIPPEWA FALLS WI
54729-5034
US

IV. Provider business mailing address

475 CHIPPEWA MALL DR
CHIPPEWA FALLS WI
54729-5034
US

V. Phone/Fax

Practice location:
  • Phone: 715-720-3780
  • Fax:
Mailing address:
  • Phone: 715-720-3780
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number323458-31
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: