Wagner, Michael C

Wagner, Michael C is an sole proprietor health care provider with primary practice located at 603 N Logan Ave , Danville IL 61832-4320. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as his primary health care specialty. Wagner, Michael C can be contacted via phone (217) 213-5254.

Contact Information

Primary practice address
603 N Logan Ave Danville IL 61832-4320
Phone: (217) 213-5254
Fax: (217) 213-5240
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 209003483 Illinois

Profile Details

NPI number 1073655825
LBN Legal business name Wagner, Michael C
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 12th, 2007
Last updated Nov 17th, 2010 - about 16 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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