GRACE ELIZABETH WAGNER

PEORIA, IL
NPI1871164418
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy363LP0200X Nurse Practitioner, Pediatrics
(Licence: IL  209021274)
Enumeration Date2021-07-06
Last Update Date2021-07-06
Business Address
GRACE ELIZABETH WAGNER DNP, APRN, CPNP
8600 STATE ROUTE 91 STE 200
PEORIA, IL 61615-7833
Phone number: 309-692-1030
Mailing Address
GRACE ELIZABETH WAGNER DNP, APRN, CPNP
2223 VETERANS RD UNIT 14
MORTON, IL 61550-4559
Phone number: 563-676-5628
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