IndividualActive
Amanda Wagner
NPI 1164058020 · Certified Registered Nurse Anesthetist · Rolla, MO
Provider details
- NPI number
- 1164058020
- Entity type
- Individual
- Primary specialty
- Certified Registered Nurse AnesthetistPhysician Assistants & Advanced Practice Nursing Providers
- Sex
- Female
- Sole proprietor
- No
- License
- RN9407106 (FL)
Practice location
1000 W 10th St
Rolla, MO 65401
Phone: (573) 458-8899
Fax: (573) 341-5611
Mailing address
1050 W 10th St
Rolla, MO 65401-2905
Registry dates
- Enumerated
- 2020-03-22
- Last updated
- 2024-09-11
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.