| Doctor Name: | MRS. ANDREA S WAGNER |
| NPI Number: | 1043455397 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CNP |
| License Number: | RN331993 |
| Business Practice Address: | 3857 Dayspring Dr Hilliard, OH - 430265723 |
| Business Phone Number: | 6147226017 |
| Business Fax Number: | |
| Mailing Address: | 3857 Dayspring Dr, HILLIARD |
| State: | OH |
| Postal Code: | 430265723 |
| Phone Number: | 6147226017 |
| Fax Number: | |
| NPI Enumeration Date: | 12/15/2008 |
| NPI Last Update Date: | 10/08/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2100X |
| License Number: | RN331993 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Acute Care |
| Taxonomy Definition: | |