Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
JENNIFER RAE WAGNER, MA, LAT
Active Sole ProprietorJENNIFER RAE WAGNER, MA, LAT is a Athletic Trainer healthcare provider located in LANCASTER, Wisconsin. NPI 1174582274 is currently active in the NPPES registry. Verify at CMS.
Athletic Trainer · LANCASTER, WI
Registration Details
- NPI Number
- 1174582274
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Mar 20, 2006 (20.393081951473 yrs)
- Last Updated
- Apr 16, 2014
- License
-
1002-39 (WI)
- Sole Proprietor
- Yes
Practice Information
- Address
-
507 S MONROE STLANCASTER, WI, 538132054Browse WI providers · Browse ZIP 53813
- Phone
- 6087233236
- Fax
- 6087233379
- Primary Specialty
-
Athletic Trainer
2255A2300X
Other Athletic Trainer Providers in LANCASTER, WI
| Name | Credential | NPI |
|---|---|---|
| MR. DAVID GERARD RECKER | MA, LAT, CSCS | 1962661199 |
| MEGAN E MEZERA | LAT, ATC | 1255804068 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.