Lynn K Wagner, MD is a
Emergency Medicine physician based in De Pere, Wisconsin. Lynn K Wagner is licensed to practice in Wisconsin (license number 49400) and her current practice location is 106 N Wisconsin St, De Pere, Wisconsin. She can be reached at her office (for appointments etc.) via phone at
(920) 327-7056.
NPI number for Lynn K Wagner is 1164458899 and her current mailing address is 164 N Broadway, Green Bay, Wisconsin. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1164458899.
Physician's Profile
| Full Name | Lynn K Wagner |
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| Gender | Female |
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| Speciality | Emergency Medicine |
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| Location | 106 N Wisconsin St, De Pere, Wisconsin |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1164458899
- Provider Enumeration Date: 06/24/2006
- Last Update Date: 05/22/2018
Medical Identifiers
Medical identifiers for Lynn K Wagner such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1164458899 | NPI | - | NPPES |
| 104894116 | Medicaid | MI | |
| 34870800 | Medicaid | WI | |
| P00355797 | Other | WI | RAILROAD |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 207P00000X | Emergency Medicine | A89772 (California) | Secondary |
| 207P00000X | Emergency Medicine | 49400 (Wisconsin) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Lynn K Wagner is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
Lynn K Wagner, MD 164 N Broadway, Green Bay, WI 54303-2728 Ph: (920) 490-9046 | Lynn K Wagner, MD 106 N Wisconsin St, De Pere, WI 54115 Ph: (920) 327-7056 |
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