person
Mrs. Carolyn Wagner, NP
Family Nurse Practitioner in Decatur, Illinois
NPI 1366419087

Carolyn Wagner is a Family Nurse Practitioner based in Decatur, IL and is specialized in Family. Carolyn Wagner practices in Decatur, IL and has the professional credentials of NP. The NPI Number for Carolyn Wagner is 1366419087 and holds a License No. 209-001389 (Illinois).

The current practice location address for Carolyn Wagner is 1770 E Lake Shore Dr, Decatur, IL and can be reached out via phone at 217-429-9700 and via fax at 217-429-9702.

Location: 1770 E Lake Shore Dr, Decatur, IL, 62521-3832
person
Provider Profile Details
NPI Number
1366419087
Provider Name
Carolyn Wagner
Credential
NP
Provider Entity Type
Individual
Gender
Female
Address
1770 E Lake Shore Dr, Decatur, IL, 62521-3832
Phone Number
217-429-9700
Fax Number
217-429-9702
Provider Enumeration Date
03/01/2006
Last Update Date
03/08/2024
institution
Provider Business Practice Location Address Details
Address
1770 E Lake Shore Dr
City
State
Zip
62521-3832
Phone Number
217-429-9700
Fax Number
217-429-9702
person
Provider Business Mailing Address Details
Address
1770 E Lake Shore Dr
City
State
Zip
62521-3832
Phone Number
217-429-9700
Fax Number
217-429-9702
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
License No.
209-001389 (Illinois)
Definition
Definition to come...
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