NPI 1063380061
Niki Wagner
Practice location
- Address
- 3240 S Woodruff Ave, Idaho Falls, ID 83404-8305
- Phone
- (208) 974-5200
Registered specialties
Case Manager/Care Coordinator
Primary
Registry record
- NPI
- 1063380061
- Entity type
- Individual
- Sex (as registered)
- Female
- NPI issued
- 29 Oct 2025
- Record last updated
- 28 Jul 2026
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.