MR. BRENTON PAUL WAGNER (NPI# 1326539578) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326539578 |
| Entity Type | Individual |
| Full Name | MR. BRENTON PAUL WAGNER |
| Credential | CNP |
| Practice Address |
4801 Acorn Dr Ste B Independence OH 44131-2566 |
| Practice Telephone | 2166625600 |
| Practice Fax Number | 2166631474 |
| Mailing Telephone | 2166625600 |
| Mailing Fax Number | 2166631474 |
| Enumeration Date | 2018-05-23 |
| Last Update Date | 2018-05-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
APRN.CNP.022596 | OH | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
4801 ACORN DR STE B |
| City | INDEPENDENCE |
| State | OH |
| Zip Code | 44131-2566 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902457161 | Emilie Hadley | Case Manager/Care Coordinator | 5700 Rockside Rd, Independence, OH 44131 | 2019-09-27 |
| 1316404015 | Denise Ann Shannon | Licensed Practical Nurse | 4700 Rocksde Road, Suite 100, Independence, OH 44131 | 2019-02-28 |
| 1255898433 | Elizabeth Spence | Specialist/Technologist | 806 Tuxedo Ave, Brooklyn Hts, OH 44131 | 2019-02-25 |
| 1407356819 | Stefani Smithburger | Social Worker | 6200 Rockside Woods Blvd, Suite 305, Independence, OH 44131 | 2018-02-13 |
| 1881107092 | Christine M Hernandez | Nurse Practitioner | 2150 Oak Tree Blvd Suite 200, Independence, OH 44131 | 2017-11-09 |
| 1639698368 | Jessica Ann Phillips-donnelly | Social Worker | 5001 Rockside Road, Crown Center II, Independence, OH 44131 | 2017-09-13 |
| 1437692274 | Susan Meghan Davis | Registered Nurse | 925 Keynote Circle Suite #300, Brooklyn Hts, OH 44131 | 2016-11-28 |
| 1629431507 | Patricia Lynn Berger | Counselor | 6200 Rockside Woods Blvd. Suite 305, Independence, OH 44131 | 2016-03-30 |
| 1265810428 | Sarah Krakowiak | Speech-Language Pathologist | 3330 Wynde Tree Drive, Seven Hills, OH 44131 | 2015-05-08 |
| 1255732525 | Michelle Rioux-nivens | Nurse Practitioner | 6150 Oak Tree Boulevard, Suite 200, Independence, OH 44131 | 2014-09-05 |
| Find all providers in zip 44131 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255944815 | Lauren Narduzzi | Nurse Practitioner | 8755 Hillside Rd, Independence, OH 44131-5424 | 2020-08-24 |
| 1699303735 | Aaron Mccoy | Nurse Practitioner | 11509 Staffordsburg Rd, Independence, KY 41051-7759 | 2020-04-01 |
| 1851922629 | Integrated Health and Wellness LLC | Nurse Practitioner | 281 Martin Luther King Jr St, Independence, LA 70443-2386 | 2020-01-30 |
| 1467010298 | Francina Contessa Whitley | Nurse Practitioner | 17020 E Us Highway 40 Ste 5&6, Independence, MO 64055-5361 | 2019-06-05 |
| 1033777545 | Joshua Clayton Smith | Nurse Practitioner | 12613 E 41st Ter S, Independence, MO 64055-4420 | 2019-05-30 |
| 1649791468 | Danielle Davone Boguslaw | Nurse Practitioner | 4731 S Cochise Dr Ste 100, Independence, MO 64055-6975 | 2017-07-01 |
| 1063951101 | April Altice | Nurse Practitioner | 815 N Noland Rd Ste 6, Independence, MO 64050-2975 | 2017-02-22 |
| 1184173924 | Tina Michelle Ross | Nurse Practitioner | 1500 W White Oak St, Independence, MO 64050-2559 | 2016-09-21 |
| 1477907830 | Christina M Reser | Nurse Practitioner | 16912 E Hart Ave, Independence, MO 64055-3040 | 2016-04-21 |
| 1295198182 | Jennifer J Allen | Nurse Practitioner | 2310 Castle Drive, Independence, MO 64057 | 2016-03-30 |
| Find all providers in INDEPENDENCE | ||||
| City | INDEPENDENCE |
| Zip Code | 44131 |
Please comment or provide details below to improve the information on MR. BRENTON PAUL WAGNER.
| 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.