TAMMY L WAGSTAFF (NPI# 1780162560) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780162560 |
| Entity Type | Individual |
| Full Name | TAMMY L WAGSTAFF |
| Credential | APRN-CNP |
| Practice Address |
16208 Juliet Dr Edmond OK 73013-9235 |
| Practice Telephone | 4053089654 |
| Mailing Telephone | 4054092897 |
| Mailing Fax Number | 4056071339 |
| Enumeration Date | 2018-08-02 |
| Last Update Date | 2020-08-27 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
78819 | OK | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1000 N Lee Ave, Oklahoma City, OK 731021036 | 4052727000 | |
| 608 Nw 9th St Ste 3206, Oklahoma City, OK 731021049 | 4057724338 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366627291 | Tammy Wagstaff | Counselor | 42669 Garfield Rd, Clinton Twp, MI 48038-5036 | 2008-01-09 |
| Street Address |
16208 JULIET DR |
| City | EDMOND |
| State | OK |
| Zip Code | 73013-9235 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407461866 | Alison Church-pugh | Case Manager/Care Coordinator | 1441 Kelley Pointe Pkwy, Edmond, OK 73013 | 2020-09-12 |
| 1699395343 | Dental Specialists of Edmond | Dentist | 16430 Muirfield Pl, Edmond, OK 73013 | 2020-04-23 |
| 1104477215 | Kammerer Richey LLC | Nurse Practitioner | 902 Nw 139th Street Parway, Edmond, OK 73013 | 2019-09-20 |
| 1811459191 | Peak Movement Centre, Pllc | Clinic/Center | 13816 Santa Fe Crossing Dr, Edmond, OK 73013 | 2019-04-04 |
| 1851858492 | Luma Hilal | Pharmacist | 2228 Nw 15th Terrace, Edmond, OK 73013 | 2019-03-01 |
| 1578031571 | Oklahoma Wellness Group LLC | Internal Medicine | 14101 North Esatern Avenue Suite B, Edmond, OK 73013 | 2018-11-07 |
| 1477034395 | Specialty Care Pediatrics, Inc. | Home Health | 2256 Nw 164th Street, Edmond, OK 73013 | 2018-08-28 |
| 1972083921 | Pooja Bhakta | Physician Assistant | Stanbro Healthcare Group LLC, 2000 E. 15th St., Suite 400-a, Edmond, OK 73013 | 2018-08-20 |
| 1417460577 | Oklahoma Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 15103 N Macarthur Blvd, Oklahoma City, OK 73013 | 2017-11-13 |
| 1356879753 | Shawn Smith Optimal Pt and Performance, Pllc | Physical Therapist | 336 Ne 145th Pl, Edmond, OK 73013 | 2017-05-30 |
| Find all providers in zip 73013 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457951519 | Crystal Marie Mapes | Nurse Practitioner | 1920 E 2nd St Apt 4015, Edmond, OK 73034-6385 | 2020-10-28 |
| 1568069185 | Ancie Madden | Nurse Practitioner | 153 Ledgemont Dr, Edmond, OK 73013-1693 | 2020-10-06 |
| 1932712973 | Katrina Michelle Todd | Nurse Practitioner | 3908 Lakeshire Ridge Ct, Edmond, OK 73034-1049 | 2020-08-28 |
| 1215554662 | Emily Kathyrn Cockrell | Nurse Practitioner | 133 Kimberly Dr, Edmond, OK 73003-2376 | 2020-07-01 |
| 1982226361 | Covid Busters, LLP | Nurse Practitioner | 1632 Camden Way, Edmond, OK 73013-2939 | 2020-05-08 |
| 1235759291 | Sara Elizabeth Lacy-antonelli | Nurse Practitioner | 311 S Rankin St, Edmond, OK 73034-5345 | 2020-04-20 |
| 1528608551 | Stacey Lynn Lowery | Nurse Practitioner | 16212 Scissortail Dr, Edmond, OK 73013-9422 | 2020-01-07 |
| 1104477215 | Kammerer Richey LLC | Nurse Practitioner | 902 Nw 139th Street Parway, Edmond, OK 73013 | 2019-09-20 |
| 1700447356 | Jeana Backus | Nurse Practitioner | 2017 W I 35 Frontage Rd Ste 170, Edmond, OK 73013-8558 | 2019-06-25 |
| 1366001315 | Kara Nicole De La Pena | Nurse Practitioner | 1501 N Midwest Blvd, Edmond, OK 73034-8412 | 2019-06-12 |
| Find all providers in EDMOND | ||||
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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.