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General NPI Number Information
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NPI Number | 1265391056
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Entity Type | Individual
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Provider Name | EMILY CHRISTINE WAGNER FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 01/19/2026
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Last Update Date | 01/19/2026
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Provider Practice Location Address
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Address Line | 100 WASHINGTON AVE S STE 1210
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City | MINNEAPOLIS
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State | MN
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Zip | 55401-2511
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Country | US
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Telephone | 866-492-5336
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Fax |
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Provider Business Mailing Address
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Address Line | 7643 DUTCHER RD
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City | FAIRGROVE
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State | MI
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Zip | 48733-9754
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Country | US
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Telephone | 989-528-0838
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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 | 363LS0200X
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Taxonomy Name | School Nurse Practitioner
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License Number | 4704376428
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License Number State | MI
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