STEPHANIE A WAGNER (NPI# 1811430655) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811430655 |
| Entity Type | Individual |
| Full Name | STEPHANIE A WAGNER |
| Credential | PNP |
| Practice Address |
411 E Chestnut St # Street6 Louisville KY 40202-1713 |
| Mailing Address |
Po Box 776879 Chicago IL 60677-6879 |
| Practice Telephone | 5025883650 |
| Practice Fax Number | 5025887852 |
| Mailing Telephone | 5025889490 |
| Mailing Fax Number | 5022725116 |
| Enumeration Date | 2016-11-28 |
| Last Update Date | 2020-10-29 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363L00000X | Nurse Practitioner | 71006717A | IN | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
71006717A | IN | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982169918 | Stephanie Ann Wagner | Nurse Practitioner | 5601 Loch Raven Blvd Bldg Suite502, Baltimore, MD 21239-2945 | 2019-02-04 |
| 1538633797 | Stephanie L Wagner | Massage Therapist | 1106 W Market St, York, PA 17404-3414 | 2019-01-21 |
| 1417466301 | Stephanie Wagner | Doula | 23 Abbey Ln Nw, Cartersville, GA 30120-7739 | 2017-09-24 |
| 1427412733 | Stephanie Lynn Wagner | Registered Nurse | 181 E 119th St Apt 8b, New York, NY 10035-4080 | 2016-04-12 |
| 1922346964 | Stephanie Wagner | Nurse Practitioner | 77 Bayview St, Belfast, ME 04915-6709 | 2013-01-25 |
| 1851928881 | Stephanie Bing Wagner | Pediatrics | 593 Eddy St, Providence, RI 02903 | 2020-03-27 |
| 1386120731 | Stephanie Wagner | Social Worker | 403 Stoney Landing Rd, Moncks Corner, SC 29461-3967 | 2018-07-18 |
| 1922591361 | Stephanie Wagner | Rehabilitation Practitioner | 43520 Division St, Lancaster, CA 93535-4089 | 2018-06-11 |
| 1477065472 | Stephanie Wagner | Occupational Therapist | 4562 Westinghouse St Ste A, Ventura, CA 93003-5797 | 2017-10-30 |
| 1487177812 | Stephanie Lynn Wagner | Behavior Technician | 452 N Eola Rd, Aurora, IL 60502-9612 | 2017-07-18 |
| Street Address |
411 E CHESTNUT ST # STREET6 |
| City | LOUISVILLE |
| State | KY |
| Zip Code | 40202-1713 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114332236 | Amanda Brian Rogers | Pediatrics | 411 E Chestnut St # Street6, Louisville, KY 40202-1713 | 2014-06-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972129682 | Garvit Chhabra | Student in an Organized Health Care Education/Training Program | 550, South Jackson Street, Acb, Third Floor, Louisville, KY 40202 | 2020-06-18 |
| 1396367009 | Richele Williams | Student in an Organized Health Care Education/Training Program | 201 Abraham Flexner Way Department of Family and Pediac, Suite 690, Louisville, KY 40202 | 2020-05-15 |
| 1942822028 | Ahmed Khaled Saleh | Student in an Organized Health Care Education/Training Program | 500 S Jackson St, Room 305, Louisville, KY 40202 | 2020-05-12 |
| 1457972952 | Mir Ali Raza Talpur | Student in an Organized Health Care Education/Training Program | 401 E Chestnut Street, Suite 600 University of Louisvi, Louisville, KY 40202 | 2020-05-06 |
| 1316575533 | Abigail Hatfield | Student in an Organized Health Care Education/Training Program | Internal Medicine Training Program, 550 South Jackson Street, Acb 3rd Floor, Louisville, KY 40202 | 2020-04-01 |
| 1851929210 | Madison Harmon | Student in an Organized Health Care Education/Training Program | Uofl Department of Emergency Medicine, 530 S. Jackson Street Room C1h17, Louisville, KY 40202 | 2020-03-31 |
| 1184252041 | Marianna Weaver | Student in an Organized Health Care Education/Training Program | 550 South Jackson Street, Acb 3rd Floor, University of Louisville, Louisville, KY 40202 | 2020-03-27 |
| 1700347341 | Charles Jake Sadle | Student in an Organized Health Care Education/Training Program | Office of Medical Education C/o Brittney Luckett, 571 S. Floyd St., Ste. 412, Louisville, KY 40202 | 2019-03-27 |
| 1437616794 | Paladina Health, LLC | Family Medicine | Paladina Health Humana East, 123 E Main Street, Louisville, KY 40202 | 2019-02-22 |
| 1205393568 | Paladina Health, LLC | Family Medicine | Paladina Health Humana West, 500 W Main Street, Louisville, KY 40202 | 2019-02-22 |
| Find all providers in zip 40202 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326695255 | Norton Childrens Medical Group, LLC | Nurse Practitioner | 1930 Bishop Ln Ste 101710th, Louisville, KY 40218-1921 | 2019-08-26 |
| 1407402209 | Elleanor Gray | Nurse Practitioner | 411 E Chestnut St Ste 645, Louisville, KY 40202-1713 | 2019-08-16 |
| 1245287440 | Tammy A Pasko | Nurse Practitioner | 234 E. Gray St., Ste. 270, Louisville, KY 40202-1903 | 2006-05-31 |
| 1013988351 | Kellie Woodruff | Nurse Practitioner | 411 E Chestnut St # Street7, Louisville, KY 40202-1713 | 2006-01-26 |
| 1639172554 | Sharon C Metcalf | Nurse Practitioner | 555 S Floyd St, Louisville, KY 40202-3801 | 2005-05-24 |
| 1619582616 | Erica Ashley Persichetti | Nurse Practitioner | 90 Health Park Dr Ste 160, Louisville, CO 80027-9742 | 2020-09-15 |
| 1295361723 | Karen A Powers | Nurse Practitioner | 411 E Chestnut St # Street7, Louisville, KY 40202-1713 | 2020-03-16 |
| 1346872074 | Elizabeth Cotton | Nurse Practitioner | 231 E Chestnut St, Louisville, KY 40202-1821 | 2020-02-11 |
| 1336771161 | Norton Children's Medical Group, LLC | Nurse Practitioner | 1930 Bishop Ln Ste 101710th, Louisville, KY 40218-1921 | 2020-02-10 |
| 1689206906 | Lacey G Sanford | Nurse Practitioner | 417 Benjamin Ln Ste 101, Louisville, KY 40222-4939 | 2020-02-05 |
| Find all providers in LOUISVILLE | ||||
| City | LOUISVILLE |
| Zip Code | 40202 |
Please comment or provide details below to improve the information on STEPHANIE A WAGNER.
| 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.