Randi L Wagner, APNP
Nurse Practitioner, Family in Milwaukee, WI. Individual provider (NPI-1).
NPI number1205410040
StatusActive
Last updated in NPPESMay 4, 2026
Details
- NPI
- 1205410040
- Entity type
- Individual (NPI-1)
- Name
- Randi L Wagner
- Credential
- APNP
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- May 7, 2021
- Certification date
- May 4, 2026
- Last updated
- May 4, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | 10938-33 | WI | Yes |
| 363L00000X | Nurse Practitioner | 10938-33 | WI |
Other names
- Randi L Ullrich (Former Name)
Practice location
342 N Water St Ste 600Milwaukee, WI 53202-5715
Phone 651-342-1039 · Fax 651-342-1428
Mailing address
270 Main St N Ste 300Stillwater, MN 55082-6788
Phone 651-342-1039 · Fax 651-342-1428
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