KELLY ANN WAGNER (NPI# 1659744316) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659744316 |
| Entity Type | Individual |
| Full Name | KELLY ANN WAGNER |
| Other Name | KELLY ANN GAITHER |
| Credential | CRNP |
| Practice Address |
10410 Abercorn Expressway Savannah GA 31419 |
| Mailing Address |
18 S Cromwell Rd Savannah GA 31410-4421 |
| Practice Telephone | 9129276832 |
| Practice Fax Number | 9129272450 |
| Mailing Telephone | 4106527666 |
| Enumeration Date | 2015-11-03 |
| Last Update Date | 2019-08-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
RN266801 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 7618 Donny Ter, Kingsville, MD 210871609 | 4106527666 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013570746 | Kelly Susan Wagner | Speech-Language Pathologist | 8902 Old Harford Rd, Baltimore, MD 21234-2646 | 2019-04-18 |
| 1356808455 | Kelly Mcmahon Wagner | Social Worker | 4701 Greenspring Ave, Baltimore, MD 21209-4704 | 2019-02-25 |
| 1659612745 | Kelly Ann Wagner | Specialist | 727 Carmen Dr, Norristown, PA 19401-3545 | 2013-03-14 |
| 1881925592 | Kelly Danielle Wagner | Physical Therapy Assistant | 226 Fish Hall Rd, Brunswick, GA 31523-7405 | 2010-01-20 |
| 1407180268 | Kelly Ann Wagner | Licensed Practical Nurse | 1143 Vogt Dr Apt 14, West Bend, WI 53095-5505 | 2009-09-28 |
| 1295288629 | Kelly Wagner | Dietitian, Registered | 200 Hawkins Dr, Food and Nutrition Services, W146 Gh, Iowa City, IA 52242-1009 | 2016-08-02 |
| 1154776334 | Kelly Wagner | Student in an Organized Health Care Education/Training Program | 100 High St, C 378, Buffalo, NY 14203-1126 | 2016-04-26 |
| 1346613205 | Kelly Wagner | Naturopath | 185 Tilley Dr, Suite #51, South Burlington, VT 05403-4484 | 2015-11-01 |
| 1932510831 | Kelly Wagner | Pharmacist | 3360 Tittabawassee Rd, Saginaw, MI 48604-9453 | 2014-05-13 |
| 1235562307 | Kelly Anne Wagner | Speech-Language Pathologist | 331 E Park St, Weiser, ID 83672-2053 | 2013-08-13 |
| Street Address |
10410 ABERCORN EXPRESSWAY |
| City | SAVANNAH |
| State | GA |
| Zip Code | 31419 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255932653 | Loving Hands Adult Care | Home Health Aide | 101 St. Goerge Blvd, 6t, Savannah, GA 31419 | 2020-11-03 |
| 1285241265 | Jennifer Ann Hales | Surgery | 11090 Mcauley, Suite 100 2a, Savannah, GA 31419 | 2020-09-24 |
| 1699318139 | Jessica Kaitlyn Matthewson | Nurse Practitioner | 11700 Mercy Blvd Plaza D, Bldg #5, Savannah, GA 31419 | 2019-10-28 |
| 1679133219 | Rebecca Denise Brown-tuyishimire | Counselor | Savannah Outpatient Clinic, 1170 Shawnee Street, Savannah, GA 31419 | 2019-06-17 |
| 1356900856 | Julio Roberto Castellanos Jr. | Behavior Technician | 785 King George Blvd Ste 103, Savannah, GA 31419 | 2019-06-07 |
| 1669941761 | Paul-david Arthur Cooper | Peer Specialist | 117 Shawnee Street, Va Savannah Clinic, Savannah, GA 31419 | 2018-11-19 |
| 1326538521 | Jay Carter Jr. | Social Worker | 1170 Shawnee St., Savannah, GA 31419 | 2018-05-14 |
| 1245771070 | Emily Robertson | Nurse Practitioner | 11133 Abercorm Street, Suite 10, Savannah, GA 31419 | 2017-03-13 |
| 1760833750 | Cady-jo Steidle | Behavioral Analyst | 143 Sugar Mill Cir, Savannah, GA 31419 | 2016-06-30 |
| 1265881189 | Mallory Williams | Physician Assistant | 11909 D. Mcauley Drive, Savannah, GA 31419 | 2016-06-10 |
| Find all providers in zip 31419 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093316820 | Odyne Rose Lacossiere-dorvilus | Nurse Practitioner | 30 Myrtlewood Dr, Savannah, GA 31405-1024 | 2020-11-06 |
| 1952900383 | Micaiah Mitchell | Nurse Practitioner | 10612 Middleground Rd Apt 513, Savannah, GA 31419-1268 | 2020-10-17 |
| 1104424712 | Yolanda Michelle Miller | Nurse Practitioner | 1651 Mckinnon Dr, Savannah, GA 31404-2319 | 2020-10-15 |
| 1730795386 | Shanika Graham | Nurse Practitioner | 2330 Coakley St, Savannah, GA 31404-4947 | 2020-09-18 |
| 1508479775 | Tonya L Creasy | Nurse Practitioner | 170 Barker Dr, Savannah, TN 38372-8419 | 2020-08-28 |
| 1356952394 | Elizabeth Woods Hammond | Nurse Practitioner | 107 W Liberty St Apt 6, Savannah, GA 31401-3965 | 2020-08-13 |
| 1740898915 | Bryan S Christain | Nurse Practitioner | 340 Hodgson Ct Ste 2, Savannah, GA 31406-1523 | 2020-07-14 |
| 1841814753 | Billie Sweeney | Nurse Practitioner | 134 Horse Creek Rd, Savannah, TN 38372-2984 | 2020-06-05 |
| 1609401140 | Malika Anderson Batie | Nurse Practitioner | 1632 Cloverdale Dr, Savannah, GA 31415-7814 | 2020-03-05 |
| 1760017206 | Evelia Johnsen | Nurse Practitioner | 11702 Mercy Blvd Ste 2g, Savannah, GA 31419-1777 | 2020-03-05 |
| Find all providers in SAVANNAH | ||||
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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.