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

Jacqueline Lee Wagner, ARNP

Individual provider Family Medicine Physician · NPI 1447598362

Jacqueline Lee Wagner, ARNP is a Nurse Practitioner in Coeur D Alene, Idaho. Qualified in 2012, 14 years ago. Practices as a sole proprietor, accepts Medicare assignment and offers telehealth. Licensed in Idaho.

Years since qualifying
14
Licensed in
ID
In the registry since
2013
What do these letters mean?
ARNP — Advanced Registered Nurse Practitioner
The title some states use for an advanced practice nurse.

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Practice location Address checks out

1713 E Sherman Ave
Coeur D Alene, ID 83814-5326
Phone: (208) 966-4087
Fax: (208) 966-4031
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence NP1283A (ID)

Record details

NPI number1447598362
Entity typeIndividual (Type 1)
GenderFemale
Credentials ARNP
Sole proprietorYes
NPI enumeratedJanuary 28, 2013
Last updated in NPPESAugust 17, 2016

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2012 (14 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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