ANGELA MICHELLE WAGNER (NPI# 1679032163) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679032163 |
| Entity Type | Individual |
| Full Name | ANGELA MICHELLE WAGNER |
| Credential | PMHNP-BC |
| Practice Address |
1077 State Route 28 Ste 202 Milford OH 45150-4000 |
| Mailing Address |
10200 Alliance Rd Ste 150 Blue Ash OH 45242-4754 |
| Practice Telephone | 5138332170 |
| Practice Fax Number | 5139649670 |
| Mailing Telephone | 5139754673 |
| Mailing Fax Number | 5138912838 |
| Enumeration Date | 2019-03-14 |
| Last Update Date | 2020-03-05 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
APRN.CNP.023469 | OH | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
5011542 | NC | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ANCC - BOARD CERTIFICATION | 2018009202 | 01 | |
| NC | NORTH CAROLINA STATE BOARD OF NURSING - ADVANCED PRACTICE LICENS | 5011542 | 01 |
| OH | OHIO BOARD OF NURSING ADVANCED PRACTICE LICENSE | APRN.CNP.023469 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 44 Bonnie Ln, Sylva, NC 28779 | 8286313973 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912152612 | Angela Marie Wagner | Physical Therapist | 125 Orange St, Nantucket, MA 02554-4028 | 2008-11-21 |
| 1093326126 | Angela Wagner | Speech-Language Pathologist | 950 Office Park Rd Ste 100, West Des Moines, IA 50265-2548 | 2020-08-12 |
| 1538678446 | Angela Wagner | Community Health Worker | 1680 Chambers St, Eugene, OR 97402-3655 | 2017-09-22 |
| 1306254628 | Angela Diane Wagner | Physical Therapist | 100 Little Dr, Lower Burrell, PA 15068-3345 | 2014-07-30 |
| 1437565025 | Angela Wagner | Massage Therapist | 3313 Patriot Ct, Herrin, IL 62948-3782 | 2014-07-03 |
| 1346667730 | Angela Wagner | Social Worker | 1 Medical Center Drive, Social Work - 122, Clarksburg, WV 26301 | 2014-03-24 |
| 1598814584 | Angela I Wagner | Occupational Therapist | 705 E Taylor St, Prairie Du Chien, WI 53821-2110 | 2007-01-09 |
| 1225137813 | Angela K. Wagner | Counselor | 325 9th Ave, Box 359735, Seattle, WA 98104-2420 | 2006-09-21 |
| 1073531711 | Angela D Wagner | Physician Assistant | 700 1st Ave S, Fargo, ND 58103-1802 | 2006-07-18 |
| 1710928270 | Angela B Wagner | Neuromusculoskeletal Medicine & OMM | 5926 Crawfordsville Rd Unit B, Indianapolis, IN 46224-3722 | 2006-06-08 |
| Street Address |
1077 STATE ROUTE 28 STE 202 |
| City | MILFORD |
| State | OH |
| Zip Code | 45150-4000 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780281899 | Emily Nicole Albacarys | Speech-Language Pathologist | 1099 Oh-131, Milford, OH 45150 | 2020-10-02 |
| 1306403118 | Baymark Health Services of Ohio | Clinic/Center | 749c State Route 28, Milford, OH 45150 | 2019-05-28 |
| 1881188878 | Lena M Todd | Counselor | 950 Lila Ave, Milford, OH 45150 | 2018-06-21 |
| 1457879678 | Kiley Buchanan | Specialist/Technologist | 1280 Eagle Ridge Road, Milford, OH 45150 | 2017-09-07 |
| 1144746488 | Amy Jo Pruitt | Speech-Language Pathologist | 7247 Zoar Road, Maineville, OH 45150 | 2017-08-18 |
| 1669911285 | Derek Jordan | Counselor | 25 Whitney Drive, Suite 122, Milford, OH 45150 | 2017-02-15 |
| 1073057998 | Tina Chioua | Home Health Aide | 1189 Mellie Ln, Milford, OH 45150 | 2016-12-12 |
| 1902258015 | Megan Fisher | Optometrist | 1064 State Route 26 Suite B, Milford, OH 45150 | 2016-07-13 |
| 1669826509 | Justin Kyle Short | Counselor | 50 West Techne Dr. Suite B-5, Milford, OH 45150 | 2016-04-18 |
| 1659794592 | Soodabeh Zia-ebrahmi | Pharmacist | 1082 Sr 28, Meijer Pharmacy, Milford, OH 45150 | 2014-01-29 |
| Find all providers in zip 45150 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972867695 | Susan J Boorin | Nurse Practitioner | 120 Broad St, Milford, CT 06460-4725 | 2012-06-27 |
| 1124301023 | Roxann Jean Hackbarth | Nurse Practitioner | 1004 21st St, Suite #3, Milford, IA 51351-7421 | 2011-09-27 |
| 1083748214 | Patrick Lynn Gagnon | Nurse Practitioner | 80 E Broadway Apt D, Milford, CT 06460-6120 | 2007-03-16 |
| 1023195765 | Christine S Simpson | Nurse Practitioner | 45 Wildemere Ave, Milford, CT 06460-5354 | 2006-11-01 |
| 1427168111 | Ruth Sposili | Nurse Practitioner | 11 Norman Cir, Milford, CT 06460-4234 | 2006-08-30 |
| 1245256692 | Laura Giesman | Nurse Practitioner | 52 W Main St, Suite 905, Milford, CT 06460-3310 | 2006-07-15 |
| 1336664598 | Anthony Michael Trezza | Nurse Practitioner | 949 Bridgeport Ave, Milford, CT 06460-3142 | 2017-08-09 |
| 1609391978 | Desiree Marie Thomas | Nurse Practitioner | 247 Broad St, Milford, CT 06460-3273 | 2017-08-08 |
| 1124569157 | Shoreline Neuropsychiatric Services, LLC | Nurse Practitioner | 215 Broad St, Unit 2w, Milford, CT 06460-4760 | 2017-03-09 |
| 1821542408 | Fresh Pathways | Nurse Practitioner | 57 Plains Rd, Milford, CT 06461-2573 | 2016-08-11 |
| Find all providers in MILFORD | ||||
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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.