All Medicaid billing entities listing WAGNER, JACQUELINE (OWNER) as their authorized official in the NPPES registry.
| State | Entities | Total Paid |
|---|---|---|
| Idaho | 1 | $298K |
| # | Provider | Location | Specialty | Total Paid |
|---|---|---|---|---|
| 1 | FAMILY PRACTICE BY THE LAKE LLC | COEUR D ALENE, ID | Nurse Practitioner | $298K |