MRS. ERNESTINE A WAGNER (NPI# 1124072889) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124072889 |
| Entity Type | Individual |
| Full Name | MRS. ERNESTINE A WAGNER |
| Credential | PA |
| Practice Address |
2417 Post Road Building A Stevens Point WI 54481 |
| Mailing Address |
2417 Post Road Building A Stevens Point WI 54481 |
| Practice Telephone | 7156901272 |
| Practice Fax Number | 7155441212 |
| Mailing Telephone | 7156901272 |
| Mailing Fax Number | 7155441212 |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2015-06-02 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | 978 | WV | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
1289-23 | WI | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
0110001577 | VA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | 10319951 | 05 | |
| WV | BRICKSTREET | 3001613 | 01 |
| WV | BLUE CROSS BLUE SHIELD | 001836169 | 01 |
| Street Address |
2417 POST ROAD BUILDING A |
| City | STEVENS POINT |
| State | WI |
| Zip Code | 54481 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790309649 | County of Portage | Clinic/Center | 1519 Water Street, Stevens Point, WI 54481 | 2020-06-05 |
| 1700400736 | Sarai Sophia Holbrook | Speech-Language Pathologist | Room 038 Cps, 1901 Fourth Ave., Uw-stevens Point, Stevens Point, WI 54481 | 2020-06-05 |
| 1164994117 | Copperleaf Home Health Inc | Homemaker | 1077 Wilshire Blvd, Stevens Point, WI 54481 | 2018-12-31 |
| 1568980274 | Melissa Jean Gutierrez | Dental Hygienist | 941 Michigan Ave, Stevens Point, WI 54481 | 2017-09-01 |
| 1164946026 | Brittany Rose Larocque | Chiropractor | 3908 Green Ct, Stevens Point, WI 54481 | 2017-08-01 |
| 1245750009 | Alyssa Kate Koth | Speech-Language Pathologist | Rm 038 Cps 1901 Fourth Ave, Unviersity of Wisconsin-stevens Point, Stevens Point, WI 54481 | 2017-06-22 |
| 1881133734 | Teri Jean Edlebeck | Specialist/Technologist | 1017 Williams Street, Stevens Point, WI 54481 | 2017-02-13 |
| 1215475892 | Valerie Lynn Fons | Dental Hygienist | 941 Michigan Avenue, Stevens Point, WI 54481 | 2017-02-03 |
| 1427509439 | Tanner Ozanne | Chiropractor | 2212 Division St, Stevens Point, WI 54481 | 2016-10-14 |
| 1134594765 | Dana Fredrickson | Registered Nurse | 616 Franklin St, Stevens Point, WI 54481 | 2015-12-08 |
| Find all providers in zip 54481 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053748855 | Kimberly A Brown | Physician Assistant | 500 Vincent St, Stevens Point, WI 54481-1842 | 2013-10-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093348542 | Christopher Sean Lanctin | Physician Assistant | 557 N 17th St Apt 310, Milwaukee, WI 53233-2128 | 2020-02-12 |
| 1750936068 | Javier Eugenio Font | Physician Assistant | 813 N Clover Ln, Cottage Grove, WI 53527-9433 | 2019-08-04 |
| 1962056432 | Lyndsey Marie Bratberg | Physician Assistant | F&mcw Clinical Cancer Center 9200 W. Wisconsin Ave., Milwaukee, WI 53226 | 2019-08-01 |
| 1588225544 | Hannah Elizabeth Krum | Physician Assistant | S80w17784 Brennan Dr, Muskego, WI 53150-8828 | 2019-06-21 |
| 1255825162 | Katelyn Marie Frankwick | Physician Assistant | 1011 E Spruce St # 6, Abbotsford, WI 54405-9647 | 2018-06-15 |
| 1831644228 | Megan E Nelson | Physician Assistant | 221 E Mills Dr, Lake Mills, WI 53551-1910 | 2016-08-16 |
| 1356717904 | Amy Hermus | Physician Assistant | 451 Butternut Dr, Oregon, WI 53575-1349 | 2015-08-18 |
| 1497168066 | Alexander J Hill | Physician Assistant | 1111 North Road, Mauston, WI 53948-0700 | 2014-06-11 |
| 1487083242 | Andrew John Miller | Physician Assistant | 1521 Lakeview Ave, Wausau, WI 54401-6168 | 2013-11-02 |
| 1386944502 | Bethany Rose Yard | Physician Assistant | 18601 Lincoln Street, Whitehall, WI 54773 | 2010-10-22 |
| Find all providers with the same taxonomy | ||||
| City | STEVENS POINT |
| Zip Code | 54481 |
Please comment or provide details below to improve the information on MRS. ERNESTINE 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.