Wagner, Grace Elizabeth
Wagner, Grace Elizabeth is an sole proprietor health care provider with primary practice located at 8600 State Route 91 Ste 200 , Peoria IL 61615-7833. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, which is considered as her primary health care specialty. Wagner, Grace Elizabeth can be contacted via phone (309) 692-1030.Contact Information
Primary practice address
8600 State Route 91 Ste 200
Peoria IL 61615-7833
Phone: (309) 692-1030
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Pediatrics | 363LP0200X | 209021274 | Illinois |
Profile Details
| NPI number | 1871164418 |
|---|---|
| LBN Legal business name | Wagner, Grace Elizabeth |
| Credentials | DNP, APRN, CPNP |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 6th, 2021 |
| Last updated | Jul 6th, 2021 - about 4 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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