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General NPI Number Information
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NPI Number | 1093577884
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Entity Type | Individual
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Provider Name | RACHAEL WAGNER RN
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Gender | Female
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Dates
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Enumeration Date | 01/26/2024
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Last Update Date | 10/31/2025
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Provider Practice Location Address
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Address Line | 2940 IMMOKALEE RD STE 2
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City | NAPLES
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State | FL
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Zip | 34110-1409
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Country | US
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Telephone | 407-721-1220
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Fax |
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Provider Business Mailing Address
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Address Line | 2940 IMMOKALEE RD STE 2
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City | NAPLES
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State | FL
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Zip | 34110-1409
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | APRN11043221
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN9424428
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License Number State | FL
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