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

Randi L Wagner, APNP

Individual provider Nurse Practitioner · NPI 1205410040

Randi L Wagner, APNP is a Nurse Practitioner in Milwaukee, Wisconsin. Qualified in 2020, 6 years ago. Practices with Bluestone Physician Services Wisconsin SC, a 31-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Wisconsin.

Years since qualifying
6
Licensed in
WI
In the registry since
2021
Specialties on file
2
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Practice location Address checks out

342 N Water St Ste 600
Milwaukee, WI 53202-5715
Phone: (651) 342-1039
Fax: (651) 342-1428
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 10938-33 (WI)
Nurse Practitioner Taxonomy 363L00000X · Licence 10938-33 (WI)

Record details

NPI number1205410040
Entity typeIndividual (Type 1)
GenderFemale
Credentials APNP
Sole proprietorNo
NPI enumeratedMay 7, 2021
Last updated in NPPESMay 4, 2026
Certification dateMay 4, 2026

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Bluestone Physician Services Wisconsin Sc — 31 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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