Individual provider Active NPI

Heather A Wagner, CNS

  • Clinical Nurse Specialist
  • Cedarburg, WI
National Provider Identifier
1376422725
Registry record updated Aug 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Nurse SpecialistTaxonomy code 364S00000X
License
177617-30 Issued in WI
Practice address
N49W7951 Western Rd
Cedarburg, WI 53012-9023
Phone
(414) 232-2301
NPI assigned
Aug 29, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Nurse Specialist 364S00000X 177617-30 WI Primary

Addresses

Primary practice location

N49W7951 Western Rd
Cedarburg, WI 53012-9023

Mailing address

N49W7951 Western Rd
Cedarburg, WI 53012-9023
Phone (414) 232-2301

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Certified Nurse Specialist

State licenses

LicenseStateTypeSpecialty
177617-30WIMDClinical Nurse Specialist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1756425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756425600000",
    "number": "1376422725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N49W7951 WESTERN RD",
            "city": "CEDARBURG",
            "state": "WI",
            "postal_code": "530129023",
            "telephone_number": "414-232-2301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N49W7951 WESTERN RD",
            "city": "CEDARBURG",
            "state": "WI",
            "postal_code": "530129023",
            "telephone_number": "414-232-2301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "HEATHER",
        "middle_name": "A",
        "credential": "CNS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-08-29",
        "last_updated": "2025-08-29",
        "certification_date": "2025-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364S00000X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist",
            "state": "WI",
            "license": "177617-30",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedarburg, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.