MRS. SUSAN RAE WAGNER (NPI# 1346695301) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346695301 |
| Entity Type | Individual |
| Full Name | MRS. SUSAN RAE WAGNER |
| Credential | NP-C |
| Practice Address |
142 Highland Dr Lebanon VA 24266-4636 |
| Mailing Address |
103 Peaceful St Clintwood VA 24228-5081 |
| Practice Telephone | 2767627600 |
| Mailing Telephone | 2762201845 |
| Enumeration Date | 2016-04-27 |
| Last Update Date | 2016-04-27 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
0024173497 | VA | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811514722 | Susan Maxine Wagner | Nurse Practitioner | 103 Hilton Cir, Enterprise, AL 36330-7815 | 2020-06-26 |
| 1154672400 | Susan Wagner | Case Manager/Care Coordinator | 12 Lancaster Rd, Island Park, NY 11558-2136 | 2012-09-26 |
| 1134420185 | Susan Carol Wagner | Social Worker | 1108 Dithridge Dr, Johnstown, PA 15905-1503 | 2010-11-08 |
| 1467776781 | Susan Elizabeth Wagner | Marriage & Family Therapist | 79 Encinal Way, Ventura, CA 93001-3317 | 2010-03-15 |
| 1275768558 | Susan J Wagner | Community Health Worker | 278 John Tuttle Rd, New Kingston, NY 12459 | 2009-05-15 |
| 1437353976 | Susan Folmar Wagner | Counselor | 1040 Allegheny Ave Sw, Ocean Crest School, Bandon, OR 97411-9034 | 2007-06-11 |
| 1508089053 | Susan Wagner | Psychologist | 223 Katonah Ave Ste Ef, Katonah, NY 10536-2146 | 2007-04-11 |
| 1144337635 | Susan M Wagner | Physical Therapist | 85 Pleasant Dr, Hastings, MN 55033-1648 | 2006-08-23 |
| 1679963482 | Susan Anglin Wagner | Counselor | 205 N Monroe St, Media, PA 19063-3052 | 2015-02-01 |
| 1609158864 | Susan Wagner | Community Health Worker | 312 Crescent St, Greenville, CA 95947 | 2011-09-14 |
| Street Address |
142 HIGHLAND DR |
| City | LEBANON |
| State | VA |
| Zip Code | 24266-4636 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275582389 | Samina Yousuf | Internal Medicine | 142 Highland Dr, Lebanon, VA 24266-4636 | 2006-05-08 |
| 1720563612 | Allison Faith Herron | Family Medicine | 142 Highland Dr, Lebanon, VA 24266-4636 | 2018-09-26 |
| 1609364785 | Kelsey Elisabeth Stapleton | Physician Assistant | 142 Highland Dr, Lebanon, VA 24266-4636 | 2018-04-25 |
| 1841643111 | Kayla Williams | Nurse Practitioner | 142 Highland Dr, Lebanon, VA 24266-4636 | 2016-07-21 |
| 1538418686 | Joye Bandy Kimbrell | Nurse Practitioner | 142 Highland Dr, Lebanon, VA 24266-4636 | 2012-09-05 |
| 1063769719 | Amanda Michele Moore | Nurse Practitioner | 142 Highland Dr, Lebanon, VA 24266-4636 | 2012-08-13 |
| 1962643403 | Shelley V Hicks | Nurse Practitioner | 142 Highland Dr, Lebanon, VA 24266-4636 | 2009-03-12 |
| 1669650354 | Rebecca Barton | Nurse Practitioner | 142 Highland Dr, Lebanon, VA 24266-4636 | 2008-02-05 |
| 1326053992 | Sidi Y Noor | Family Medicine | 142 Highland Dr, Lebanon, VA 24266-4636 | 2006-07-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114541174 | Nextdoor Drug | Pharmacist | 932 W Main St, Lebanon, VA 24266 | 2020-06-04 |
| 1720638661 | Advanced Practice Primary Care, Pllc | Nurse Practitioner | 2336 Coal Tipple Hollow, Lebanon, VA 24266 | 2019-09-12 |
| 1962051763 | Best Life Physical Therapy Inc. | Physical Therapist | 383 Technology Park Drive, Lebanon, VA 24266 | 2019-09-05 |
| 1093361024 | Alexis Rae Carson | Psychologist | 84 Dr Lorraine C. Turner Dr. Russell County Public Scho, Lebanon, VA 24266 | 2019-08-15 |
| 1457821019 | Blue Ridge Medical Management Corporation | Internal Medicine | 71 S Flannagan Ave Suite 81, Lebanon, VA 24266 | 2018-11-27 |
| 1457867202 | Elizabeth Altizer Baker | Speech-Language Pathologist | 84 Lorraine C. Turner Dr., Russell County Public Schools, Lebanon, VA 24266 | 2017-12-15 |
| 1851805683 | Laura Hankins Vencill | Speech-Language Pathologist | Russell County Public Schools, 84 Lorraine C. Turner Dr., Lebanon, VA 24266 | 2017-12-01 |
| 1487168670 | Stacy Nichole Davis | Counselor | 78 Rogers St, Lebanon, VA 24266 | 2017-11-27 |
| 1568976751 | Kelly Elizabeth Smith | Counselor | 216 Gilmer Street, Lebanon, VA 24266 | 2017-11-27 |
| 1659883312 | Sara K Poole | Occupational Therapist | 408 Fields Ave., Lebanon, VA 24266 | 2017-11-02 |
| Find all providers in zip 24266 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053912170 | Kaley Elizabeth Barrett | Nurse Practitioner | 418 Edgewood Dr, Lebanon, PA 17042-9109 | 2020-11-04 |
| 1932716420 | Jessica Erb | Nurse Practitioner | 804 Holly Ln, Lebanon, PA 17042-9028 | 2020-09-28 |
| 1922619527 | Tammy Lynn Whitt | Nurse Practitioner | 961 Poor Farm Rd, Lebanon, VA 24266-7097 | 2020-08-17 |
| 1538777529 | Shenia Diane Johnson | Nurse Practitioner | 71 S. Flannagan Ave., Lebanon, VA 24266-2426 | 2020-07-16 |
| 1275158164 | Kelly Mcdaniel | Nurse Practitioner | 288 Rolling Meadows Rd, Lebanon, VA 24266-5870 | 2020-06-16 |
| 1609498955 | Kelsey Jones | Nurse Practitioner | 1412 Nathaniel Dr, Lebanon, MO 65536-8906 | 2020-05-09 |
| 1124657887 | Shelly Prather | Nurse Practitioner | 350 Wheeler St, Lebanon, OR 97355-4349 | 2020-04-05 |
| 1205479458 | Natasha Denney Arentz | Nurse Practitioner | 5787 Oh-63, Lebanon, OH 45036 | 2019-10-21 |
| 1720638661 | Advanced Practice Primary Care, Pllc | Nurse Practitioner | 2336 Coal Tipple Hollow, Lebanon, VA 24266 | 2019-09-12 |
| 1821642430 | Jill Montgomery Major | Nurse Practitioner | 135 Knights Brg, Lebanon, TN 37090-1410 | 2019-07-31 |
| Find all providers in LEBANON | ||||
Please comment or provide details below to improve the information on MRS. SUSAN RAE 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.