MRS. SUSAN MAXINE WAGNER (NPI# 1811514722) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811514722 |
| Entity Type | Individual |
| Full Name | MRS. SUSAN MAXINE WAGNER |
| Credential | ARNP |
| Practice Address |
103 Hilton Cir Enterprise AL 36330-7815 |
| Practice Telephone | 3344779825 |
| Mailing Telephone | 3344779825 |
| Enumeration Date | 2020-06-26 |
| Last Update Date | 2020-06-26 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
11007696 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154672400 | Susan Wagner | Case Manager/Care Coordinator | 12 Lancaster Rd, Island Park, NY 11558-2136 | 2012-09-26 |
| 1134420185 | Susan Carol Wagner | Social Worker | 1108 Dithridge Dr, Johnstown, PA 15905-1503 | 2010-11-08 |
| 1467776781 | Susan Elizabeth Wagner | Marriage & Family Therapist | 79 Encinal Way, Ventura, CA 93001-3317 | 2010-03-15 |
| 1275768558 | Susan J Wagner | Community Health Worker | 278 John Tuttle Rd, New Kingston, NY 12459 | 2009-05-15 |
| 1437353976 | Susan Folmar Wagner | Counselor | 1040 Allegheny Ave Sw, Ocean Crest School, Bandon, OR 97411-9034 | 2007-06-11 |
| 1508089053 | Susan Wagner | Psychologist | 223 Katonah Ave Ste Ef, Katonah, NY 10536-2146 | 2007-04-11 |
| 1144337635 | Susan M Wagner | Physical Therapist | 85 Pleasant Dr, Hastings, MN 55033-1648 | 2006-08-23 |
| 1346695301 | Susan Rae Wagner | Nurse Practitioner | 142 Highland Dr, Lebanon, VA 24266-4636 | 2016-04-27 |
| 1679963482 | Susan Anglin Wagner | Counselor | 205 N Monroe St, Media, PA 19063-3052 | 2015-02-01 |
| 1609158864 | Susan Wagner | Community Health Worker | 312 Crescent St, Greenville, CA 95947 | 2011-09-14 |
| Street Address |
103 HILTON CIR |
| City | ENTERPRISE |
| State | AL |
| Zip Code | 36330-7815 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417566860 | Julia Brooke Lowe | Pharmacist | 847 Boll Weivell Circle #112, Enterprise, AL 36330 | 2020-07-30 |
| 1134759640 | Benjamin Chase Marler | Student in an Organized Health Care Education/Training Program | 205 Somerset Pl, Enterprise, AL 36330 | 2020-01-23 |
| 1033694492 | Angel Melton | Counselor | 105 Searcy St, Enterprise, AL 36330 | 2018-10-01 |
| 1285180729 | Enterprise Urgent Care | Clinic/Center | 6582 Boll Weevil Circle, Enterprise, AL 36330 | 2016-08-25 |
| 1902204258 | Nikki Chen | Nurse Practitioner | 805 East Lee Street, Ste C, Enterprise, AL 36330 | 2014-12-17 |
| 1568795417 | Crystal Juanita Christian | Counselor | 1275 James Drive, Suite A Enterprise Behavioral Services, Enterprise, AL 36330 | 2009-09-10 |
| 1316173206 | Robert Noback | Preventive Medicine | 301 Dustoff Ave, Ft. Rucker, AL 36330 | 2009-06-05 |
| 1184892978 | Phillip Allen Fuller | Pulmonary Function Technologist | 130e.pondella Dr., Enterprise, AL 36330 | 2008-02-14 |
| 1720266778 | Richard Bauer | Emergency Medical Technician, Intermediate | Bld 301 Andrews Ave., Lyster Army Health Clinic, Ft Rucker, AL 36330 | 2008-02-01 |
| 1871646547 | Thomas Orson Patterson | Dentist | 306 South Edwards Street, Enterprise, AL 36330 | 2007-01-18 |
| Find all providers in zip 36330 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285250670 | Dylan Reese Mccollough | Nurse Practitioner | 6582 Boll Weevil Cir, Enterprise, AL 36330-9424 | 2020-06-22 |
| 1336669472 | Jennifer Stewart | Nurse Practitioner | 114 Flatrock Dr, Enterprise, AL 36330-4457 | 2017-06-20 |
| 1528424215 | Affordable Integrated Medicine | Nurse Practitioner | 610 W North St Ste B, Enterprise, OR 97828-1427 | 2016-01-11 |
| 1689001596 | Abby Spitler Olive | Nurse Practitioner | 606 Boll Weevil Cir, Suite A, Enterprise, AL 36330-2734 | 2013-10-09 |
| 1154629178 | Ashley D Gray | Nurse Practitioner | 83a Old Mill Creek Rd, Enterprise, MS 39330-9649 | 2011-03-01 |
| 1447219886 | Michelle Diane Stewmon | Nurse Practitioner | 103 W Robertson Ct, Enterprise, AL 36330-2344 | 2006-03-23 |
| 1629061981 | Theresa A Russell | Nurse Practitioner | 406 Ne 1st St, Enterprise, OR 97828-1168 | 2005-08-23 |
| 1063925626 | Jessica E Poitevint | Nurse Practitioner | 105 E Watts St, Enterprise, AL 36330-2511 | 2017-11-06 |
| 1063956233 | Millicent R Harrison | Nurse Practitioner | 105 E Watts St, Enterprise, AL 36330-2511 | 2016-12-07 |
| 1811449812 | Hannah Elizabeth Mcqueen | Nurse Practitioner | 101 E Brunson St Ste 200, Enterprise, AL 36330-2500 | 2016-10-26 |
| Find all providers in ENTERPRISE | ||||
| City | ENTERPRISE |
| Zip Code | 36330 |
Please comment or provide details below to improve the information on MRS. SUSAN MAXINE 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.