Wagner, Bradley Thomas

Wagner, Bradley Thomas is an individual health care provider with primary practice located at 611 Sherman Ave E , Fort Atkinson WI 53538-1960. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered. Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered is his primary health care specialty. Wagner, Bradley Thomas can be contacted via phone (920) 568-5000.

Contact Information

Primary practice address
611 Sherman Ave E Fort Atkinson WI 53538-1960
Phone: (920) 568-5000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 190070-30 Wisconsin
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 190070-30 Wisconsin

Profile Details

NPI number 1043581770
LBN Legal business name Wagner, Bradley Thomas
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 26th, 2012
Last updated Oct 25th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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