MRS. KIMBERLY ANN WAGNER (NPI# 1114237575) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114237575 |
| Entity Type | Individual |
| Full Name | MRS. KIMBERLY ANN WAGNER |
| Practice Address |
1 Perryman St Lebanon IL 62254-1356 |
| Practice Telephone | 6185376165 |
| Enumeration Date | 2010-10-19 |
| Last Update Date | 2010-10-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 164W00000X | Licensed Practical Nurse | 043.085404 | IL | Nursing Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053755959 | Kimberly Wagner | Counselor | 533 Judy Ann Dr, Hahira, GA 31632-1303 | 2013-04-22 |
| 1164691465 | Kimberly H Wagner | Nurse Practitioner | 125 W Interstate 30, Royse City, TX 75189-7512 | 2008-02-21 |
| 1245352855 | Kimberly Wagner | Psychologist | 201 N Rose Ave, Room 32, Bloomington, IN 47405-1005 | 2007-04-04 |
| 1497379788 | Kimberly Ann Wagner | Registered Nurse | 6480 Technology Ave, Kalamazoo, MI 49009-8119 | 2020-06-02 |
| 1124542980 | Kimberly Marie Wagner | Specialist/Technologist | 59 Executive Park S Ste 1100, Atlanta, GA 30329-2208 | 2017-08-02 |
| 1861885477 | Kimberly Wagner | Specialist | 23936 Michigan Ave, Dearborn, MI 48124-1833 | 2015-03-07 |
| 1093154122 | Kimberly Wagner | Family Medicine | 2970 Pierce Rd, Suite 2, Saginaw, MI 48604-8810 | 2013-06-21 |
| 1588008320 | Kimberly Wagner | Counselor | 3830 S Cushman St, Fairbanks, AK 99701-7530 | 2013-04-23 |
| 1104176593 | Kimberly N Wagner | Physical Therapist | 750 Coronado Center Dr, Suite 120, Henderson, NV 89052-5034 | 2012-09-13 |
| 1922325497 | Kimberly Lue Wagner | Psychiatry & Neurology | 2312 N Nevada Ave, Suite 100, Colorado Springs, CO 80907-5302 | 2010-04-23 |
| Street Address |
1 PERRYMAN ST |
| City | LEBANON |
| State | IL |
| Zip Code | 62254-1356 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629076021 | David A Weik | Podiatrist | 1 Perryman St, Lebanon, IL 62254-1356 | 2005-07-09 |
| 1245884469 | Cedar Ridge Care and Rehabilitation Center LLC | Skilled Nursing Facility | 1 Perryman St, Lebanon, IL 62254-1356 | 2019-07-25 |
| 1003375270 | Cep America - Illinois Snf, LLP | Internal Medicine | 1 Perryman St, Lebanon, IL 62254-1356 | 2019-03-18 |
| 1578038402 | Andrea Bahan | Physical Therapist | 1 Perryman St, Lebanon, IL 62254-1356 | 2018-10-08 |
| 1740513076 | Jennifer Meyer | Speech-Language Pathologist | 1 Perryman St, Lebanon, IL 62254-1356 | 2009-09-18 |
| 1114130135 | Ashlei L Moses | Physical Therapy Assistant | 1 Perryman St, Lebanon, IL 62254-1356 | 2007-05-07 |
| 1275663445 | Covenant Care Midwest, Inc. | Skilled Nursing Facility | 1 Perryman St, Lebanon, IL 62254-1356 | 2007-03-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477788305 | Tonya Gass | Occupational Therapist | 1201 North Alton, Lebanon, IL 62254 | 2009-05-21 |
| 1679550644 | Lebanon Hco, LLC | Skilled Nursing Facility | 1201 N Alton St, Lebanon, IL 62254-1103 | 2005-12-29 |
| 1346873510 | Lebanon Hco, LLC | Skilled Nursing Facility | 1201 N Alton St, Lebanon, IL 62254-1103 | 2020-02-17 |
| 1245475664 | Elizabeth Budd Korte | Family Medicine | 420 Hillcrest Dr, Lebanon, IL 62254-1107 | 2008-12-15 |
| 1467892760 | Christy Nichole Niles | Counselor | 10918 Fallowfield Dr, Lebanon, IL 62254-1163 | 2013-07-01 |
| 1144293820 | William Edward Dill II | Specialist/Technologist | 701 College Rd, Lebanon, IL 62254-1291 | 2006-02-10 |
| 1558988519 | Blake Hudspeth | Specialist/Technologist | 701 College Rd, Lebanon, IL 62254-1291 | 2020-06-25 |
| 1255957544 | Abigail Louise Conner | Specialist/Technologist | 701 College Rd, Lebanon, IL 62254-1291 | 2020-06-22 |
| 1588280200 | Katy Renee Gayford | Specialist/Technologist | 701 College Rd, Lebanon, IL 62254-1291 | 2020-06-18 |
| 1629595509 | Joshua Parker Craig | Specialist/Technologist | 701 College Rd, Lebanon, IL 62254-1291 | 2017-08-23 |
| Find all providers in zip 62254 | ||||
| Taxonomy Code | 164W00000X |
| Grouping | Nursing Service Providers |
| Classification | Licensed Practical Nurse |
| An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states. |
| Notes: Source: Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235502295 | Keena Samples | Licensed Practical Nurse | 20 North Ln, Lebanon, OH 45036-1861 | 2015-11-12 |
| 1285032094 | Patricia Brandon | Licensed Practical Nurse | 3588 Mary Ann Dr, Lebanon, OH 45036-1001 | 2014-12-10 |
| 1407253164 | Catherine Marquez | Licensed Practical Nurse | 436 Jones St, Lebanon, PA 17046-4670 | 2014-11-24 |
| 1710307566 | Andrew Crowden | Licensed Practical Nurse | 169 Summit St, Lebanon, OH 45036-1943 | 2014-04-21 |
| 1104249796 | Melanie K Harding | Licensed Practical Nurse | 489 La Luz Blvd Apt 217, Lebanon, OH 45036-1871 | 2014-02-02 |
| 1235570144 | Loretta C Zierden | Licensed Practical Nurse | 1053-84 Hunters Run Road, Lebanon, OH 45036-8446 | 2013-07-09 |
| 1578907309 | Kristen M Leedy | Licensed Practical Nurse | 770 Oleander Ct, Lebanon, OH 45036-9099 | 2013-04-23 |
| 1205279601 | Amanda Nicole Smith | Licensed Practical Nurse | 485 Wagon Wheel Dr, Lebanon, OR 97355-3745 | 2013-04-16 |
| 1508108606 | Rebecca Smith | Licensed Practical Nurse | 1030 Hunters Run Dr, Apt 25, Lebanon, OH 45036-9191 | 2013-03-27 |
| 1275872301 | Carrie Lynn Lewis | Licensed Practical Nurse | 309 Jameson Ln, Lebanon, OH 45036-1903 | 2013-02-09 |
| Find all providers in LEBANON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.