IndividualActive
Dara Wagner, APN-C
NPI 1063046464 · Family Nurse Practitioner · Canton, IL
Provider details
- NPI number
- 1063046464
- Entity type
- Individual
- Primary specialty
- Family Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- APN-C
- Sex
- Female
- Sole proprietor
- No
- License
- 209020976 (IL)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Physician Assistants & Advanced Practice Nursing Providers
Practice location
180 S Main St
Canton, IL 61520-2608
Phone: (309) 647-0201
Approximate (ZIP-level) locationGet directions
Mailing address
180 S Main St
Canton, IL 61520-2608
Registry dates
- Enumerated
- 2020-02-25
- Last updated
- 2021-10-20
- Certified
- 2021-10-20
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.