Tyler Wagner, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

206041 Issued in ND

Practice address

1330 Page Dr S Ste 102B
Fargo, ND 58103-3562

Phone

(701) 414-4596

NPI assigned

Sep 23, 2026

Last updated

Sep 23, 2026By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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

{
    "created_epoch": "1790121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790121600000",
    "number": "1588577498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1330 PAGE DR S STE 102B",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581033562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 PAGE DR S STE 102B",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581033562",
            "telephone_number": "701-414-4596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "TYLER",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-09-23",
        "last_updated": "2026-09-23",
        "certification_date": "2026-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "ND",
            "license": "206041",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abigail Wagner
• Andrew Mark Wagner, D.C.
• Angela D Wagner, PA-C
• Meredith G Wagner, LRD
• Stacey Lynn Wagner, LSW
• Haley Faye Wahl
• Jennifer Lyn Wahl
• Rhea Kristine Wahl
• Christopher Robin Wahlen
• Rachael Ann Wahlen, RN

• Psychiatric/Mental Health Nurse Practitioner in Fargo, ND
• Providers in Fargo, ND by specialty
• Psychiatric/Mental Health Nurse Practitioner in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.