Wagner, Jenny

Wagner, Jenny is an individual health care provider with primary practice located at 100 Ne Randolph Ave , Peoria IL 61606-1919. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Wagner, Jenny can be contacted via phone (309) 624-8500.

Contact Information

Primary practice address
100 Ne Randolph Ave Peoria IL 61606-1919
Phone: (309) 624-8500
Fax: (309) 624-8552
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 209.013545 Illinois

Profile Details

NPI number 1063885556
LBN Legal business name Wagner, Jenny
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 5th, 2015
Last updated Nov 5th, 2015 - about 11 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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