| Grace Elizabeth Wagner, DNP, APRN, CPNP | |
|
8600 State Route 91 Ste 200, Peoria, IL 61615-7833 | |
| (309) 692-1030 | |
| Not Available |
| Full Name | Grace Elizabeth Wagner |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner - Pediatrics |
| Location | 8600 State Route 91 Ste 200, Peoria, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871164418 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LP0200X | Nurse Practitioner - Pediatrics | 209021274 (Illinois) | Primary |
| Entity Name | Osf Multi-specialty Group |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1922445527 PECOS PAC ID: 3678889789 Enrollment ID: O20150904000279 |
| Mailing Address | Practice Location Address |
|---|---|
| Grace Elizabeth Wagner, DNP, APRN, CPNP 2223 Veterans Rd Unit 14, Morton, IL 61550-4559 Ph: (563) 676-5628 | Grace Elizabeth Wagner, DNP, APRN, CPNP 8600 State Route 91 Ste 200, Peoria, IL 61615-7833 Ph: (309) 692-1030 |
Mr. Ryan Eugene Parnham, NP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 530 Ne Glen Oak Ave, Suite 108, Peoria, IL 61537 Phone: 309-624-8818 | |
Faye Yetton, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 2015 W Austin Dr, Peoria, IL 61614 Phone: 309-256-0632 | |
Linda Schmidgall, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 420 Ne Glen Oak Ave, Suite 200, Peoria, IL 61603 Phone: 309-624-5100 Fax: 309-624-5569 | |
Sandra L. Peach, APN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 420 Ne Glen Oak Ave, Peoria, IL 61603 Phone: 309-655-2343 Fax: 309-655-3948 | |
Roxanne Mclaughlin, APN Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 8940 N Wood Sage Rd, Peoria, IL 61615 Phone: 309-243-3000 Fax: 309-243-3274 | |
Suzanne D Tietjen, BSN, NNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 530 Ne Glen Oak Ave, Peoria, IL 61637 Phone: 309-655-2974 | |
Brittany N Hemmele, APN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 8600 N State Route 91, Peoria, IL 61615 Phone: 309-683-5050 Fax: 309-683-5335 |