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General NPI Number Information
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NPI Number | 1477160737
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Entity Type | Individual
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Provider Name | MEGHAN ANNE WAGNER MSN, ARNP
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Gender | Female
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Dates
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Enumeration Date | 09/29/2020
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Last Update Date | 01/15/2025
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Provider Practice Location Address
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Address Line | 7202 267TH ST NW STE 104
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City | STANWOOD
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State | WA
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Zip | 98292-6270
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Country | US
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Telephone | 425-263-1189
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Fax | 833-428-3954
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Provider Business Mailing Address
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Address Line | PO BOX 808
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City | STANWOOD
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State | WA
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Zip | 98292-0808
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Country | US
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Telephone | 425-263-1189
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Fax | 833-428-3954
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | AP61143462
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP61143462
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License Number State | WA
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