Jenny Wagner
Jenny Wagner is a Nurse Practitioner in Peoria, Illinois. Qualified in 2014, 12 years ago. Practices with Osf Multi-Specialty Group, a 2,128-clinician group and accepts Medicare assignment. Licensed in Illinois.
- Years since qualifying
- 12
- Licensed in
- IL
- In the registry since
- 2015
Practice location Address checks out
100 NE Randolph AvePeoria, IL 61606-1919
Phone: (309) 624-8500
Fax: (309) 624-8552
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Nurse Practitioner (primary) | Taxonomy 363L00000X · Licence 209.013545 (IL) |
|---|
Record details
| NPI number | 1063885556 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Sole proprietor | No |
| NPI enumerated | November 5, 2015 |
| Last updated in NPPES | November 5, 2015 |
| Mailing address | 100 Ne Randolph Ave, Peoria, IL 61606-1919 |
Medicare enrollment
| Medicare specialty | NURSE PRACTITIONER |
|---|---|
| Medical school | OTHER |
| Graduated | 2014 (12 years in practice) |
| Group practice | Osf Multi-Specialty Group — 2128 clinicians |
| Accepts Medicare assignment | Yes — accepts the Medicare-approved amount |
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