IndividualActive
David Wagner, RN
NPI 1366742363 · Hemodialysis Registered Nurse · Saint Louis, MO
Provider details
- NPI number
- 1366742363
- Entity type
- Individual
- Primary specialty
- Hemodialysis Registered NurseNursing Service Providers
- Credential
- RN
- Sex
- Male
- Sole proprietor
- No
- License
- 073061 (MO)
Specialties & taxonomies
Nursing Service Providers
Practice location
915 N Grand Blvd
05jc
Saint Louis, MO 63106-1621
Phone: (314) 652-4100
Fax: (314) 289-6472
Approximate (ZIP-level) locationGet directions
Mailing address
915 N Grand Blvd
Saint Louis, MO 63106-1621
Registry dates
- Enumerated
- 2010-10-25
- Last updated
- 2010-10-25
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.