Kathleen Mary Wagner in Melbourne - Nurse Practitioner
Kathleen Mary Wagner - NPI 1740397041
Kathleen Mary Wagner is a Nurse Practitioner in Melbourne, Florida. Kathleen Mary Wagner practices all healthcare services and medical treatments related to Nurse Practitioner. The NPI Number for Kathleen Mary Wagner is 1740397041. The last update date is 2012-09-07.
Kathleen Mary Wagner's current location address is 1223 Gateway Drive, Melbourne, Florida. You can contact this provider via phone number 3217254500 and fax number 3217221237. The mailing address for Kathleen Mary Wagner is 1223 Gateway Drive, Melbourne, Florida. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Kathleen Mary Wagner |
|---|---|
| Address | 1223 Gateway Drive, Melbourne, Florida |
| Phone Number | 3217254500 |
| Fax Number | 3217221237 |
| Sole Proprietor | N |
| Credentials | ARNP |
NPI Number Detail
| NPI Number | 1740397041 |
|---|---|
| Provider Enumeration Date | 2006-08-23 |
| Last Updated Date | 2012-09-07 |
Provider Mailing Address Detail
| Address | 1223 Gateway Drive |
|---|---|
| City | Melbourne |
| State | Florida (FL) |
| Post Code | 329012607 |
| Phone Number | 3217254500 |
| Fax Number | 3217221237 |
Provider's Primary Taxonomy Detail
| Speciality | Nurse Practitioner |
|---|---|
| Taxonomy | 363L00000X |
| Licence No | AP30000510 |
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Definition: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certifi |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 9649823 | WA | -- | |
| 212946 | WA | LABOR & INDUSTRIES | |
| 807564400 | ID | -- |
Post Comment/ Review Below
What is the unique 10-digit identification code assigned to Kathleen Mary Wagner by the Centers for Medicare & Medicaid Services?
The Kathleen Mary Wagner has been issued the NPI (National Provider Identifier) 1740397041, which serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you kindly provide the complete physical address where Kathleen Mary Wagner's facilities are geographically located?
The facilities of Kathleen Mary Wagner are physically situated at the following location: 1223 Gateway Drive, Melbourne, FL, 329012607.
What is the Kathleen Mary Wagner's specialty and taxonomy code?
The Kathleen Mary Wagner's specialty is Nurse Practitioner, and the corresponding taxonomy code is 363L00000X.
On what date did the Centers for Medicare & Medicaid Services assign the 1740397041 to Kathleen Mary Wagner?
The Centers for Medicare & Medicaid Services assigned the 1740397041 to Kathleen Mary Wagner on 2006-08-23.
As of what date were the details pertaining to Kathleen Mary Wagner last refreshed?
The information related to the Kathleen Mary Wagner, including its address, specialty, and other relevant details, was last updated on 2012-09-07.
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