MARY LANIER HUNTLEY-WAGNER (NPI# 1376775098) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376775098 |
| Entity Type | Individual |
| Full Name | MARY LANIER HUNTLEY-WAGNER |
| Credential | FNP |
| Practice Address |
813 Independence Blvd Virginia Beach VA 23455-6004 |
| Mailing Address |
860 Omni Blvd Ste 101 Newport News VA 23606-4430 |
| Practice Telephone | 7573337625 |
| Mailing Telephone | 7572328769 |
| Mailing Fax Number | 7572328875 |
| Enumeration Date | 2009-08-13 |
| Last Update Date | 2019-12-02 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
0024168926 | VA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
813 INDEPENDENCE BLVD |
| City | VIRGINIA BEACH |
| State | VA |
| Zip Code | 23455-6004 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922097179 | Dietrich Albert Fellner | Ophthalmology | 813 Independence Blvd, Virginia Beach, VA 23455-6004 | 2005-10-20 |
| 1588040695 | David Domachowski | Optometrist | 813 Independence Blvd, Virginia Beach, VA 23455-6004 | 2015-07-31 |
| 1770678450 | Independence Family Medicine | Family Medicine | 813 Independence Blvd, Suite A, Virginia Beach, VA 23455-6004 | 2006-10-04 |
| 1720179104 | The Eye Specialists Ltd | Optometrist | 813 Independence Blvd, Virginia Beach, VA 23455-6004 | 2006-09-28 |
| 1760456511 | Michael Vincent Moro | Family Medicine | 813 Independence Blvd, Suite A, Virginia Beach, VA 23455-6004 | 2006-02-16 |
| 1164411310 | Christine Ware Cook | Optometrist | 813 Independence Blvd, Virginia Beach, VA 23455-6004 | 2005-10-20 |
| 1124017363 | Russell Nmn Meyer | Specialist | 813 Independence Blvd, Virginia Beach, VA 23455-6004 | 2005-10-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093324162 | Evoscient Gynecology Center for Pelvic Health and Surgery, PC | Obstetrics & Gynecology | 108 Independence Blvd, Suite 162, Virginia Beach, VA 23455 | 2020-07-24 |
| 1942728571 | Delois L Dillard | Occupational Therapy Assistant | 4225 Shore Drive, Virginia Beach, VA 23455 | 2017-09-04 |
| 1295255404 | Unobs Medical Transportation Services LLC | Non-emergency Medical Transport (VAN) | 5812 Tajo Avenue, Virginia Beach, VA 23455 | 2017-06-20 |
| 1831640812 | Wearefit | Dietitian, Registered | 4752 Hollis Road, Virginia Beach, VA 23455 | 2016-10-14 |
| 1629496633 | Jamie Lauren Dermatis | Podiatrist | 1700 Pleasure Road, #101, Virginia Beach, VA 23455 | 2014-04-07 |
| 1619304664 | Syed A Absar | Pharmacist | 4828 Lake Bradford Lane, Virginia Beach, VA 23455 | 2013-10-07 |
| 1851734958 | Cara K Richardson | Occupational Therapist | 2364 Madison Ave., Virginia Beach, VA 23455 | 2013-04-09 |
| 1811249287 | Chl & Associates | Nurse Practitioner | 1367 Sir Richard Rd, Virginia Beach, VA 23455 | 2012-10-10 |
| 1588915425 | Edward S Wilson | Physician Assistant | 604 Bishop Dr, Virginia Beach, VA 23455 | 2012-10-01 |
| 1073886842 | April Gilbrech | Registered Nurse | 1103 Canopy Ct, Virginia Beach, VA 23455 | 2012-02-09 |
| Find all providers in zip 23455 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881294783 | Amy K Volk | Nurse Practitioner | 272 Bendix Rd Ste 100, Virginia Beach, VA 23452-1380 | 2020-10-29 |
| 1407462575 | Jody Lynn Glass | Nurse Practitioner | 1567 Back Bay Landing Rd, Virginia Beach, VA 23457-1338 | 2020-09-23 |
| 1063027373 | Karen Elaine Callaway | Nurse Practitioner | 937 Sunnyside Dr, Virginia Beach, VA 23464-2128 | 2020-09-14 |
| 1477177582 | Laura Michelle Rossin | Nurse Practitioner | 736 Sequoia Way, Virginia Beach, VA 23451-4471 | 2020-06-04 |
| 1356964373 | A New Day Healthcare | Nurse Practitioner | 1604 Hilltop West Ctr Ste 215, Virginia Beach, VA 23451-6196 | 2020-05-26 |
| 1710508049 | Christina Barnett | Nurse Practitioner | 1413 Dermott Ave, Virginia Beach, VA 23455-4119 | 2020-04-28 |
| 1336769934 | Leah Rose | Nurse Practitioner | 4477 Pissarro Dr, Virginia Beach, VA 23456-5468 | 2020-04-23 |
| 1174151310 | Angela Fleetwood | Nurse Practitioner | 5712 Bannock Rd, Virginia Beach, VA 23462-3904 | 2020-04-01 |
| 1508498676 | John Charles Rowe Jr. | Nurse Practitioner | 4812 Station House Ln, Virginia Beach, VA 23455-1935 | 2020-02-06 |
| 1356997613 | Alfreda Curtis | Nurse Practitioner | 1527 Brendle Ct, Virginia Beach, VA 23464-6761 | 2019-08-13 |
| Find all providers in VIRGINIA BEACH | ||||
| City | VIRGINIA BEACH |
| Zip Code | 23455 |
Please comment or provide details below to improve the information on MARY LANIER HUNTLEY-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.