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Lacy Wagner, PA
NPI 1508537507 · on the registry since 2021
Practice
- Address
- 6051 W Emerald St
Boise, ID 83704 - Phone
- (208) 302-5150
- Fax
- (208) 302-5155
- Clinicians at this address
- 57
Additional practice sites
- 1856 E Fireside Dr, Meridian, ID
Registry record
- Primary taxonomy
- Physician Assistant
363A00000X
- Also registered as
- Physician Assistant
- Licence states on file
- ID
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2022-01-26
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Idaho