GEORGINE WAGONER (NPI# 1578858999) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578858999 |
| Entity Type | Individual |
| Full Name | GEORGINE WAGONER |
| Credential | ARNP |
| Practice Address |
1407 Independence Ave 5th Floor Waterloo IA 50703-4300 |
| Practice Telephone | 3192912413 |
| Practice Fax Number | 3192912659 |
| Mailing Telephone | 3192912413 |
| Mailing Fax Number | 3192912659 |
| Enumeration Date | 2011-06-14 |
| Last Update Date | 2011-06-14 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
C-041395 | IA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1407 INDEPENDENCE AVE 5TH FLOOR |
| City | WATERLOO |
| State | IA |
| Zip Code | 50703-4300 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730203407 | County of Black Hawk | Public Health or Welfare | 1407 Independence Ave, 5th Floor, Waterloo, IA 50703-4396 | 2007-03-19 |
| 1699060004 | Rhonda Bottke | Nurse Practitioner | 1407 Independence Ave, 5th Floor, Waterloo, IA 50703-4300 | 2011-06-14 |
| 1356466239 | Black Hawk County | Public Health or Welfare | 1407 Independence Ave, 5th Floor, Waterloo, IA 50703-4396 | 2007-03-20 |
| 1659495315 | Black Hawk County | Public Health or Welfare | 1407 Independence Ave, 5th Floor, Waterloo, IA 50703-4396 | 2007-03-19 |
| 1194856799 | Black Hawk County Health Department | Public Health or Welfare | 1407 Independence Ave, 5th Floor, Waterloo, IA 50703-4396 | 2007-03-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306363841 | Kristie Wood | Counselor | 1420 W. Donald St, Waterloo, IA 50703 | 2017-08-25 |
| 1215359054 | Chuck Corwin | Counselor | 607 Sycamore Street, Suite 300, Waterloo, IA 50703 | 2014-01-14 |
| 1679672554 | Linda D Bartollas | Social Worker | 146 West Dale Street, Suite 101, Waterloo, IA 50703 | 2006-09-21 |
| 1558477745 | Brent Matthew Hintz | Obstetrics & Gynecology | 212 West Dale St., Suite 402, Waterloo, IA 50703 | 2006-08-21 |
| 1588629729 | Mir Ahmad Waziri | Pediatrics | 212 W Dale Street, Suite 302, Waterloo, IA 50703 | 2006-04-19 |
| 1568432615 | Wei Yang | Pathology | Northeast Iowa Pathology Associates, PC, 1825 Logan Avenue, Waterloo, IA 50703 | 2006-01-23 |
| 1689158040 | Megan Elizabeth O'neal | Nurse Practitioner | 1631 Logan Ave, Waterloo, IA 50703 | 2018-09-21 |
| 1972031359 | Stephanie Rose Smith | Nurse Practitioner | 1631 Logan Ave, Waterloo, IA 50703 | 2017-05-30 |
| 1801263462 | Krissy Jean Wieland | Nurse Practitioner | 220 Franklin St, Waterloo, IA 50703 | 2015-08-28 |
| 1699169698 | Jens Masters Olsen | Emergency Medicine | 1825 Logan Ave, Waterloo, IA 50703 | 2015-03-27 |
| Find all providers in zip 50703 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831498146 | Julie Louise Ritland | Nurse Practitioner | 424 Kingbard Blvd, Waterloo, IA 50701-3056 | 2011-03-25 |
| 1376192567 | Heart To Heart Pediatrics LLC | Nurse Practitioner | 224 Bradford Ln, Waterloo, IL 62298-3369 | 2019-09-10 |
| 1699060004 | Rhonda Bottke | Nurse Practitioner | 1407 Independence Ave, 5th Floor, Waterloo, IA 50703-4300 | 2011-06-14 |
| 1831427657 | Ginny M Peter | Nurse Practitioner | 224 Bradford Ln, Waterloo, IL 62298-3369 | 2009-12-07 |
| 1912130709 | Heather Slifka | Nurse Practitioner | 3421 W 9th St, Waterloo, IA 50702-5401 | 2009-08-27 |
| 1750360228 | Jane Donnette Sieleman | Nurse Practitioner | 905 Franklin St, Waterloo, IA 50703-4407 | 2006-01-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407455017 | Amy Danielle Dobberfuhl | Nurse Practitioner | 6833 Coburn Ln, Johnston, IA 50131-1243 | 2020-10-23 |
| 1326586249 | Abby Blacker | Nurse Practitioner | 10633 Nw 106th Ave, Granger, IA 50109-9775 | 2017-02-11 |
| 1457745986 | Amanda Larson | Nurse Practitioner | 420 12th St Se, Apt 16, Le Mars, IA 51031-2800 | 2015-03-23 |
| 1376951715 | Leslie Arends | Nurse Practitioner | 101 College of Nursing Building, 50 Newton Rd, Iowa City, IA 52242-1121 | 2014-07-29 |
| 1871928093 | Catherine Ann Roche | Nurse Practitioner | 5510 Utica Ridge Rd, Suite 100, Davenport, IA 52807-2946 | 2013-09-06 |
| 1063758605 | Blank Childrens Hospital | Nurse Practitioner | 6540 Ne 12th Ave, Pleasant Hill, IA 50327-8828 | 2013-01-01 |
| 1982984183 | Amanda Marie Ostergaard | Nurse Practitioner | 974 73rd Street, Suite 33, Windsor Heights, IA 50324-1026 | 2011-08-19 |
| 1033437140 | Teresa Dale Schenck | Nurse Practitioner | 400 N. 17th St, Teresa Schenck Dnp, Keokuk, IA 52632 | 2010-05-13 |
| 1538313614 | Susan E Rumelhart | Nurse Practitioner | 1243 20th St Sw, Cedar Rapids, IA 52404-1635 | 2008-11-16 |
| 1356595581 | Jill Renae Asprey | Nurse Practitioner | 720 7th Ave Sw, Cedar Rapids, IA 52404-1921 | 2008-11-14 |
| 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.