COURTNEY LEE WAGNER (NPI# 1295914331) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295914331 |
| Entity Type | Individual |
| Full Name | COURTNEY LEE WAGNER |
| Credential | LPN |
| Practice Address |
6261 Old Bethel Rd Crestview FL 32536-5507 |
| Mailing Address |
221 Hospital Dr Ne Fort Walton Beach FL 32548-5066 |
| Practice Telephone | 8506837500 |
| Practice Fax Number | 8506837523 |
| Mailing Telephone | 8508339240 |
| Enumeration Date | 2007-10-25 |
| Last Update Date | 2007-10-25 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 164W00000X | Licensed Practical Nurse | PN5178468 | FL | Nursing Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306409982 | Courtney Jo Wagner | Student in an Organized Health Care Education/Training Program | 625 19th St S, Birmingham, AL 35233-1900 | 2019-04-18 |
| 1619304904 | Courtney Anne Wagner | Physician Assistant | 1598 S County Trl Ste 100, East Greenwich, RI 02818 | 2013-10-01 |
| 1154682417 | Courtney Dawn Wagner | Case Manager/Care Coordinator | 2300 Foothill Blvd, Rock Springs, WY 82901-5610 | 2012-06-04 |
| 1073818878 | Courtney Ann Wagner | Physician Assistant | 1 Barnes Jewish Hospital Plz, Saint Louis, MO 63110-1003 | 2011-01-26 |
| 1891927802 | Courtney M Wagner | Physical Therapist | 27650 Ferry Rd, 100, Warrenville, IL 60555-3845 | 2009-08-10 |
| Street Address |
6261 OLD BETHEL RD |
| City | CRESTVIEW |
| State | FL |
| Zip Code | 32536-5507 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346426764 | Maranda Nicole Massey | Registered Nurse | 6261 Old Bethel Rd, Crestview, FL 32536-5507 | 2008-01-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831684901 | Eva Maria I Matute | Adult Companion | 6050 Trestle St, Crestview, FL 32536 | 2018-06-29 |
| 1669989232 | Lauren Estep Flowers | Physician Assistant | 550 Redstone Ave W Ste 370, Crestview, FL 32536 | 2018-01-04 |
| 1427444868 | Jessie Huisken | Social Worker | 5890 Saratoga Dr, Crestview, FL 32536 | 2015-04-13 |
| 1679846166 | John D. Carlson Md | Specialist | 492 North Wilson Street, Crestview, FL 32536 | 2012-02-15 |
| 1154609691 | Alternative Living, Inc. | Assisted Living Facility | 603 North Pearl Street, Crestview, FL 32536 | 2011-08-02 |
| 1487821526 | Michael G Foley Md Pa | Internal Medicine | 524 James Lee Blvd W, Crestview, FL 32536 | 2008-05-08 |
| 1184805830 | Advanced Family Medicine Clinic Inc | Family Medicine | 327 Medcrest Drive, Unit A, Crestview, FL 32536 | 2007-11-23 |
| 1164631511 | Caring Hearts Pediatric Extended Care Center, Inc | Clinic/Center | 380 Medcrest Dr, Crestview, FL 32536 | 2007-05-22 |
| 1669697751 | Crestview Chiropractic Clinic, Inc. | Chiropractor | 1078 S. Ferdon Boulevard, Suite A, Crestview, FL 32536 | 2007-04-16 |
| 1457492886 | Roy M Nakaiye | Dentist | 222 Cedar Ave, Crestview, FL 32536 | 2007-02-09 |
| Find all providers in zip 32536 | ||||
| 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 |
|---|---|---|---|---|
| 1134308265 | Kimberly Kay Freeman | Licensed Practical Nurse | 501 4th Ave, Crestview, FL 32536-2539 | 2007-10-25 |
| 1770762817 | Aimee Lynn Keller | Licensed Practical Nurse | 425 Adams Dr, Crestview, FL 32536-1605 | 2007-10-25 |
| 1053590182 | Amanda Faye Garrett | Licensed Practical Nurse | 650 S Pearl St, Crestview, FL 32539-4222 | 2007-10-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558962175 | Talor Meigs | Licensed Practical Nurse | 870 Mande Ct, Shalimar, FL 32579-2303 | 2020-11-02 |
| 1871192070 | Layata Shaundria Twitty-kiser | Licensed Practical Nurse | 2521 Spring Forest Road, Tallahassee, FL 32301 | 2020-10-20 |
| 1841898657 | Tamesha L Montgomery | Licensed Practical Nurse | 112 Stock Ave, Interlachen, FL 32148-5095 | 2020-10-14 |
| 1346857299 | Ieshia Nesbitt | Licensed Practical Nurse | 9633 Ne 2nd Dr, Wildwood, FL 34785-8440 | 2020-09-24 |
| 1205443207 | Cheryl Elaine Dowdell | Licensed Practical Nurse | 1685 Biscayne Bay Cir, Jacksonville, FL 32218-8671 | 2020-09-24 |
| 1366057796 | Djuana M Carter | Licensed Practical Nurse | 1837 Lake Chapman Dr Unit 202, Brandon, FL 33510-4169 | 2020-09-11 |
| 1881208130 | Myra Louise Peoples | Licensed Practical Nurse | 4473 Se Village Rd, Stuart, FL 34997-8234 | 2020-09-03 |
| 1417560731 | Melanie Reyes | Licensed Practical Nurse | 968 Allendale Rd, West Palm Beach, FL 33405-1346 | 2020-08-26 |
| 1003429788 | Meline St Pierre | Licensed Practical Nurse | 6607 Willow Street, Zellwood, FL 32798 | 2020-08-24 |
| 1427669134 | Phedia Jean Baptiste | Licensed Practical Nurse | 4709 Nw 9th Dr, Plantation, FL 33317-1482 | 2020-08-14 |
| Find all providers with the same taxonomy | ||||
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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.