Individual ProviderAmy WagnerNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address937 Highland Blvd Ste 5410, Bozeman, MT 59715-6916(406) 414-2400(406) 414-5000PECOS EnrollmentBased on the most recent information from CMS, provider Amy Wagner is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1174935688Provider TypeIndividualFull NameWagner, AmyCredentialFNP-CGenderFemaleSole ProprietorNoEnumeration Date6/2/2014Last Updated4/9/2025Contact InformationPractice LocationPractice Address937 Highland Blvd Ste 5410, Bozeman, MT 59715-6916Phone(406) 414-2400Fax(406) 414-3610Mailing LocationMailing Address915 Highland Blvd, Bozeman, MT 59715-6902Phone(406) 414-5000FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363LF0000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense146465MontanaProvider IdentifiersIDDescriptionIssuerID1174935688DescriptionMedicaidIssuerUnlistedMontana