Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Erica Bohlke Wagner, PA

Individual provider Medical Physician Assistant · NPI 1053810846

Erica Bohlke Wagner, PA is a Physician Assistant in Eagan, Minnesota. Qualified in 2017, 9 years ago. Practices with Fairview Clinics, a 806-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in Minnesota.

Years since qualifying
9
Licensed in
MN
In the registry since
2018
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

3305 Central Park Village Dr Ste 200
Eagan, MN 55121-7707
Phone: (651) 406-8860
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1158 Island Blvd, Welch, MN 55089-9540 — (651) 385-4148

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence 12588 (MN)

Record details

NPI number1053810846
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorYes
NPI enumeratedFebruary 7, 2018
Last updated in NPPESOctober 30, 2023
Certification dateOctober 30, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Fairview Clinics — 806 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations5 on file with Medicare

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