ANGELA D WAGNER (NPI# 1073531711) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073531711 |
| Entity Type | Individual |
| Full Name | ANGELA D WAGNER |
| Other Name | ANGELA D DIEDE |
| Credential | PA-C |
| Practice Address |
700 1st Ave S Fargo ND 58103-1802 |
| Mailing Address |
2401 41st St S Ste 101 Fargo ND 58104-7783 |
| Practice Telephone | 7012344023 |
| Practice Fax Number | 7012344050 |
| Mailing Telephone | 7012344023 |
| Mailing Fax Number | 7012344050 |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2020-09-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PAC0344 | ND | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ND | 71059 | 05 | |
| MN | 186186700 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679032163 | Angela Michelle Wagner | Nurse Practitioner | 1077 State Route 28 Ste 202, Milford, OH 45150-4000 | 2019-03-14 |
| 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 |
| 1710928270 | Angela B Wagner | Neuromusculoskeletal Medicine & OMM | 5926 Crawfordsville Rd Unit B, Indianapolis, IN 46224-3722 | 2006-06-08 |
| Street Address |
700 1ST AVE S |
| City | FARGO |
| State | ND |
| Zip Code | 58103-1802 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700872157 | Harry C Weiser | Neurological Surgery | 700 1st Ave S, Fargo, ND 58103-1802 | 2005-09-21 |
| 1538783972 | Austin Fridrich | Physician Assistant | 700 1st Ave S, Fargo, ND 58103-1802 | 2020-06-02 |
| 1144842089 | Matthew Hockert | Physician Assistant | 700 1st Ave S, Fargo, ND 58103-1802 | 2020-05-14 |
| 1770110777 | Steffani Nicole Johnston Mack | Physician Assistant | 700 1st Ave S, Fargo, ND 58103-1802 | 2020-03-27 |
| 1457912529 | Dillon F Grose | Nurse Practitioner | 700 1st Ave S, Fargo, ND 58103-1802 | 2019-06-27 |
| 1629639919 | Paul Rodenbiker | Nurse Practitioner | 700 1st Ave S, Fargo, ND 58103-1802 | 2019-06-26 |
| 1477053411 | Sara Amys | Physician Assistant | 700 1st Ave S, Fargo, ND 58103-1802 | 2018-02-16 |
| 1881193803 | Rachael Burns | Physician Assistant | 700 1st Ave S, Fargo, ND 58103-1802 | 2018-02-05 |
| 1457872889 | Jaydee Unruh | Nurse Practitioner | 700 1st Ave S, Fargo, ND 58103-1802 | 2017-07-06 |
| 1205377793 | Behzad Sabit | Neurological Surgery | 700 1st Ave S, Fargo, ND 58103 | 2017-03-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659924843 | Amanda Hericks | Dentist | 1338 Gateway Drive S, Fargo, ND 58103 | 2019-07-17 |
| 1285298240 | Ann Louise Breen | Optometrist | Sanford Southpointe Eye Center & Optical, 2400 32nd Ave. S., Fargo, ND 58103 | 2019-04-25 |
| 1245706597 | Lisa Elaine Livingston | Counselor | 1337 14 and Half St. S., Fargo, ND 58103 | 2018-10-15 |
| 1528569662 | Misty Lynn Hagen | Counselor | 901 28th St. South, Suite B, Fargo, ND 58103 | 2018-02-23 |
| 1083133011 | Faith Homecare Professionals LLC | Home Health | 304 25th St S, Suite B, Fargo, ND 58103 | 2017-09-11 |
| 1982138749 | Matthew Troyer | Pharmacist | 2425 13th Ave, Fargo, ND 58103 | 2017-04-18 |
| 1801338504 | Amy Nguyen Christianson | Chiropractor | 1650 45th St S Ste 113, Fargo, ND 58103 | 2016-11-11 |
| 1245772359 | Andrea Marie Hanson | Nurse Practitioner | 2400 32nd Ave South, Fargo, ND 58103 | 2016-11-07 |
| 1831647940 | Abigail Carmen Burkett Vetter | Nurse Practitioner | 2928 University Dr S Suite 101, Fargo, ND 58103 | 2016-09-18 |
| 1013361302 | Nancy Knowlton | Speech-Language Pathologist | 3001 11th Ave S, Beyond Boundaries Speech-language, Fargo, ND 58103 | 2016-04-22 |
| Find all providers in zip 58103 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205015633 | Jamie M Brown | Physician Assistant | 1711 Gold Dr S, Suite 170, Fargo, ND 58103-6416 | 2007-11-02 |
| 1790703353 | Mary Jane Kadry | Physician Assistant | 1121 Westrac Dr S Ste 204, Fargo, ND 58103-2385 | 2006-07-18 |
| 1861419723 | Catherine M Garvey | Physician Assistant | 2801 University Dr S, Fargo, ND 58103-6029 | 2006-07-16 |
| 1881148005 | Kali Luecke | Physician Assistant | 301 Np Ave N, Fargo, ND 58102-4835 | 2016-08-04 |
| 1215480009 | Jason Byrne Smith | Physician Assistant | 801 Broadway N, Fargo, ND 58102-3641 | 2016-07-27 |
| 1659758381 | Sarah Winter | Physician Assistant | 1702 University Dr S, Fargo, ND 58103-4940 | 2015-05-01 |
| 1861801763 | Lisa Lynn Froemke | Physician Assistant | 3838 12th Ave N, Fargo, ND 58102-2931 | 2014-08-05 |
| 1033525365 | Kathryn Gray | Physician Assistant | 301 Np Ave N, Fargo, ND 58102-4835 | 2014-07-08 |
| 1326462490 | Shannon Lynn Gullingsrud | Physician Assistant | 3000 32nd Ave S, Fargo, ND 58103-6132 | 2014-02-10 |
| 1467722702 | Yan Tesch | Physician Assistant | 2400 32nd Ave S, Fargo, ND 58103-5800 | 2012-01-04 |
| Find all providers in FARGO | ||||
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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.