Wagner, Dara Marie

Wagner, Dara Marie is an individual health care provider with primary practice located at 180 S Main St , Canton IL 61520-2608. She 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 / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Wagner, Dara Marie can be contacted via phone (309) 647-0201.

Contact Information

Primary practice address
180 S Main St Canton IL 61520-2608
Phone: (309) 647-0201
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 209020976 Illinois
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 209020976 Illinois

Profile Details

NPI number 1063046464
LBN Legal business name Wagner, Dara Marie
Credentials APN-C
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 25th, 2020
Last updated Oct 20th, 2021 - 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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