KIMBERLY WAGNER (NPI# 1588008320) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588008320 |
| Entity Type | Individual |
| Full Name | KIMBERLY WAGNER |
| Credential | B.S. |
| Practice Address |
3830 S Cushman St Fairbanks AK 99701-7530 |
| Practice Telephone | 9074555254 |
| Enumeration Date | 2013-04-23 |
| Last Update Date | 2013-04-23 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AK | MH0157 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053755959 | Kimberly Wagner | Counselor | 533 Judy Ann Dr, Hahira, GA 31632-1303 | 2013-04-22 |
| 1164691465 | Kimberly H Wagner | Nurse Practitioner | 125 W Interstate 30, Royse City, TX 75189-7512 | 2008-02-21 |
| 1245352855 | Kimberly Wagner | Psychologist | 201 N Rose Ave, Room 32, Bloomington, IN 47405-1005 | 2007-04-04 |
| 1497379788 | Kimberly Ann Wagner | Registered Nurse | 6480 Technology Ave, Kalamazoo, MI 49009-8119 | 2020-06-02 |
| 1124542980 | Kimberly Marie Wagner | Specialist/Technologist | 59 Executive Park S Ste 1100, Atlanta, GA 30329-2208 | 2017-08-02 |
| 1861885477 | Kimberly Wagner | Specialist | 23936 Michigan Ave, Dearborn, MI 48124-1833 | 2015-03-07 |
| 1093154122 | Kimberly Wagner | Family Medicine | 2970 Pierce Rd, Suite 2, Saginaw, MI 48604-8810 | 2013-06-21 |
| 1104176593 | Kimberly N Wagner | Physical Therapist | 750 Coronado Center Dr, Suite 120, Henderson, NV 89052-5034 | 2012-09-13 |
| 1114237575 | Kimberly Ann Wagner | Licensed Practical Nurse | 1 Perryman St, Lebanon, IL 62254-1356 | 2010-10-19 |
| 1922325497 | Kimberly Lue Wagner | Psychiatry & Neurology | 2312 N Nevada Ave, Suite 100, Colorado Springs, CO 80907-5302 | 2010-04-23 |
| Street Address |
3830 S CUSHMAN ST |
| City | FAIRBANKS |
| State | AK |
| Zip Code | 99701-7530 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235265430 | Bonnie Abbey | Counselor | 3830 S Cushman St, Fairbanks, AK 99701-7530 | 2007-02-24 |
| 1902252570 | Laquawna M Baker | Social Worker | 3830 S Cushman St, Fairbanks, AK 99701-7530 | 2016-05-12 |
| 1710332713 | Akeela Inc | Community/Behavioral Health | 3830 S Cushman St, Fairbanks, AK 99701-7530 | 2016-04-27 |
| 1043679889 | Cara Hollingsworth | Registered Nurse | 3830 S Cushman St, Fairbanks, AK 99701-7530 | 2016-02-22 |
| 1700250917 | Danielle Denise Nelson | Counselor | 3830 S Cushman St, Fairbanks, AK 99701-7530 | 2015-11-25 |
| 1265800379 | Michaela Cameron | Counselor | 3830 S Cushman St, Fairbanks, AK 99701-7530 | 2015-09-04 |
| 1093183220 | Susanne Jenemann | Marriage & Family Therapist | 3830 S Cushman St, Fairbanks, AK 99701-7530 | 2015-09-03 |
| 1972987998 | Fairbanks Community Mental Health Services, LLC | Psychologist | 3830 S Cushman St, Fairbanks, AK 99701-7530 | 2015-07-20 |
| 1689071441 | Catherine Jibben | Registered Nurse | 3830 S Cushman St, Fairbanks, AK 99701-7530 | 2014-11-21 |
| 1396141834 | Jessica Mckay | Social Worker | 3830 S Cushman St, Fairbanks, AK 99701-7530 | 2014-11-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659984987 | Resource Center for Parents & Children, Inc. | Social Worker | 726 26th Ave, Suite #2, Fairbanks, AK 99701 | 2020-08-26 |
| 1134738982 | Aaron Paul Sarauer | Behavior Technician | 3121 Lathrop St., Fairbanks, AK 99701 | 2020-07-28 |
| 1437715505 | Fabienne Rose Marie Siddall | Case Manager/Care Coordinator | 122 1st Avenue, Fairbanks, AK 99701 | 2019-05-14 |
| 1902461957 | Jacqueline Marie Rahm | Counselor | Family Centered Services of Alaska - Rtc, 3101 Lathrop St., Fairbanks, AK 99701 | 2019-05-06 |
| 1821588989 | Corrie Wilson | Nurse Practitioner | 1025 Barnette Street, Fairbanks, AK 99701 | 2018-05-15 |
| 1922519305 | Sarishma Sangeeta Lal | Registered Nurse | 815 2nd Ave Ste 122, Fairbanks, AK 99701 | 2017-10-12 |
| 1245690569 | Christine L Simko | Naturopath | 1275 Sadler Way, Ste 100 Rm 147, Fairbanks, AK 99701 | 2016-02-29 |
| 1932581600 | Jennifer Davis | Registered Nurse | 1025 West Barnette St., Fairbanks, AK 99701 | 2015-06-18 |
| 1700272705 | John D. Zipperer Jr Md, LLC | Clinic/Center | 751 Old Richardson Hwy., Fairbanks, AK 99701 | 2015-04-07 |
| 1578957460 | Mara Justine Becker | Physician Assistant | 1717 W. Cowles St, Fairbanks, AK- ALASKA 99701 | 2015-03-27 |
| Find all providers in zip 99701 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326674706 | Emily Low | Counselor | 1569 La Rue Ln, Fairbanks, AK 99709-6671 | 2020-03-18 |
| 1215578703 | Jesse Brooks | Counselor | 1203 26th Ave, Fairbanks, AK 99701-6832 | 2019-10-05 |
| 1548818008 | Tamela Eleasia Edwards | Counselor | 946 Cowles St Ste 106, Fairbanks, AK 99701-4381 | 2019-08-28 |
| 1538713946 | John Moses | Counselor | 4027 Birch Ln, Fairbanks, AK 99709-3517 | 2019-07-25 |
| 1124687140 | Galdys Duncan | Counselor | 122 1st Ave Ste 6001221, Fairbanks, AK 99701-4871 | 2019-06-12 |
| 1902461957 | Jacqueline Marie Rahm | Counselor | Family Centered Services of Alaska - Rtc, 3101 Lathrop St., Fairbanks, AK 99701 | 2019-05-06 |
| 1851854798 | Siena Counseling, LLC | Counselor | 565 University Ave Ste 4, Fairbanks, AK 99709-3688 | 2019-04-08 |
| 1588134381 | Birch Tree Counseling LLC | Counselor | 600 University Ave Ste 6, Fairbanks, AK 99709-3651 | 2018-12-05 |
| 1669967451 | Jennifer Hood Lpc, LLC | Counselor | 626 2nd St Ste 103, Fairbanks, AK 99701-3466 | 2018-06-25 |
| 1922590918 | Kathryn Chatterton Mallory | Counselor | 318 Slater St, Fairbanks, AK 99701-2923 | 2018-06-05 |
| Find all providers in FAIRBANKS | ||||
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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.