MELISSA ANNE WAGNER (NPI# 1417598491) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417598491 |
| Entity Type | Individual |
| Full Name | MELISSA ANNE WAGNER |
| Other Name | MELISSA ANNE GONDER |
| Credential | CRNP |
| Practice Address |
2701 Blair Mill Rd Suite 20 Willow Grove PA 19090 |
| Practice Telephone | 2156727070 |
| Practice Fax Number | 2156726426 |
| Mailing Telephone | 2156727070 |
| Mailing Fax Number | 2156726426 |
| Enumeration Date | 2019-10-01 |
| Last Update Date | 2019-10-01 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
SP020001 | PA | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932664075 | Melissa R Wagner | Counselor | 1824 Ratchford Dr, Dallas, NC 28034-7528 | 2019-02-03 |
| 1306408109 | Melissa Anne Wagner | Registered Nurse | 5500 Armstrong Rd, Battle Creek, MI 49037-7314 | 2019-07-01 |
| 1073006037 | Melissa Marie Wagner | Speech-Language Pathologist | 8848 Red Oak Blvd Ste Aa, Charlotte, NC 28217-5595 | 2018-06-13 |
| 1275077265 | Melissa Hart Wagner | Occupational Therapist | 120 Cavette Hill Ln, Rehab Department, Knoxville, TN 37934-6673 | 2016-12-09 |
| 1356891105 | Melissa Wagner | Nurse Practitioner | 22 S Greene St, Baltimore, MD 21201-1544 | 2016-10-05 |
| 1174992382 | Melissa Dalton Wagner | Nurse Practitioner | 64 Kirk Plz, Inez, KY 41224 | 2015-09-17 |
| 1366843229 | Melissa Wagner | Psychologist | 3443 W Shaw Ave, Fresno, CA 93711-3249 | 2014-09-10 |
| 1063820710 | Melissa Wagner | Radiologic Technologist | 1970 Roanoke Blvd, Salem, VA 24153-6404 | 2014-07-25 |
| 1366763708 | Melissa Sue Wagner | Nurse Practitioner | 400 S Kingshighway Blvd, Saint Louis, MO 63110-1014 | 2010-06-21 |
| 1639338478 | Melissa A Wagner | Massage Therapist | 207 W Summit St, Souderton, PA 18964-2054 | 2008-06-06 |
| Street Address |
2701 BLAIR MILL RD SUITE 20 |
| City | WILLOW GROVE |
| State | PA |
| Zip Code | 19090 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538161591 | Abington Surgical Center, P.C. | Specialist | 2701 Blair Mill Rd, Ste 35, Willow Grove, PA 19090-1041 | 2005-06-02 |
| 1447524533 | Desiree M Trader-kent | Nurse Practitioner | 2701 Blair Mill Rd, Suite 20, Willow Grove, PA 19090-1041 | 2012-03-07 |
| 1942536909 | Lorileen C Bautista | Nurse Practitioner | 2701 Blair Mill Rd, Willow Grove, PA 19090-1041 | 2009-10-27 |
| 1306009618 | Rebecca Mulry Straubel | Nurse Practitioner | 2701 Blair Mill Rd, Northwood Bldg Suite C, Willow Grove, PA 19090-1041 | 2008-07-07 |
| 1083898787 | Keystone Mobile Partners, Lp | Clinic/Center | 2701 Blair Mill Rd, Ste. 30, Willow Grove, PA 19090-1041 | 2007-12-18 |
| 1134315369 | Montgomery County Advanced Medical Imaging, LLC | Clinic/Center | 2701 Blair Mill Rd, Blairwood Bldg. Suite 9, Willow Grove, PA 19090-1041 | 2007-09-20 |
| 1093909533 | Jessica M. Klemens | Obstetrics & Gynecology | 2701 Blair Mill Rd, Suite C, Willow Grove, PA 19090-1041 | 2007-08-28 |
| 1619167459 | Urology for Children | Specialist | 2701 Blair Mill Rd, Ste 6, Willow Grove, PA 19090-1041 | 2007-07-27 |
| 1407064165 | Kevin R Booth | Psychiatry & Neurology | 2701 Blair Mill Rd, Ste 8, Willow Grove, PA 19090-1041 | 2007-05-18 |
| 1003022500 | Venkatesh Sundararajan | Anesthesiology | 2701 Blair Mill Rd, #35, Willow Grove, PA 19090-1041 | 2007-05-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073122495 | Orna Kempler Azulay | Speech-Language Pathologist | 3515 W Moreland Rd, Willow Grove, PA 19090 | 2020-07-31 |
| 1396205654 | Randi Lynn Murat | Physical Therapist | 2500 W Moreland Rd Ste 2103, Willow Grove, PA 19090 | 2019-03-22 |
| 1780173690 | Garden Spring Center Snf LLC | Skilled Nursing Facility | 1113 North Easton Road, Willow Grove, PA 19090 | 2018-05-07 |
| 1740778976 | Dean Depice | Chiropractor | 1031 North York Rd, Willow Grove, PA 19090 | 2018-04-24 |
| 1679081095 | Darnell Marie Lorick | Registered Nurse | 1553 Rothley Ave, Willow Grove, PA 19090 | 2018-01-19 |
| 1750809364 | Eileen Black | Counselor | 4 Neshaminy Interplex Suite 202, Trevose, PA 19090 | 2017-09-03 |
| 1538615760 | Sarah Herstich | Social Worker | 208 N Easton Rd, Willow Grove, PA 19090 | 2016-08-28 |
| 1902252091 | Christina Amodei | Physical Therapist | 2519 Maryland Rd #250, Willowgrove, PA 19090 | 2016-05-09 |
| 1568838340 | Insights Counseling & Consulting LLC | Counselor | 2300 Computer Ave., C13, Willow Grove, PA 19090 | 2015-08-17 |
| 1376949016 | Courtney M Dedda | Physical Therapist | 1003 Easton Rd Ste 105c, Willow Grove, PA 19090 | 2014-11-07 |
| Find all providers in zip 19090 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659812675 | Tetyana Demkovych | Nurse Practitioner | 2729 Henry Ave, Willow Grove, PA 19090-3020 | 2017-03-09 |
| 1750613980 | Jordan Mount | Nurse Practitioner | 140 Woodlyn Ave, Willow Grove, PA 19090-3736 | 2010-02-15 |
| 1093907735 | Donna Clare Townsend | Nurse Practitioner | 1944 Lukens Ave, Willow Grove, PA 19090-3022 | 2007-08-16 |
| 1831723956 | Donna M Trigone | Nurse Practitioner | 2360 Maryland Road, Rheumatic Disease Associates Ltd, Willow Grove, PA 19090-1709 | 2020-02-27 |
| 1013302496 | Michelle Anderson | Nurse Practitioner | 735 Fitzwatertown Rd, #a, Willow Grove, PA 19090-1338 | 2015-04-01 |
| 1710311378 | Michelle Reily | Nurse Practitioner | 3941 Commerce Ave, Willow Grove, PA 19090-1104 | 2013-08-30 |
| 1447524533 | Desiree M Trader-kent | Nurse Practitioner | 2701 Blair Mill Rd, Suite 20, Willow Grove, PA 19090-1041 | 2012-03-07 |
| 1730300583 | Wendolyn Ruthe Grace | Nurse Practitioner | 2360 Maryland Rd, Willow Grove, PA 19090 | 2007-05-01 |
| 1881783660 | Megan O'connor Grugan | Nurse Practitioner | 2701 Blair Mill Rd, Suite 10, Willow Grove, PA 19090-1041 | 2006-10-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053912170 | Kaley Elizabeth Barrett | Nurse Practitioner | 418 Edgewood Dr, Lebanon, PA 17042-9109 | 2020-11-04 |
| 1891395406 | Eimy Aguilar | Nurse Practitioner | 18 Descartes Dr, Lancaster, PA 17603-8861 | 2020-11-01 |
| 1134729775 | Jacqueline A Ouma | Nurse Practitioner | 4530 Clairton Blvd, Pittsburgh, PA 15236-2112 | 2020-10-30 |
| 1932709912 | Sheri Lynn Tittelmayer | Nurse Practitioner | 1012 Rozel Ave, Southampton, PA 18966-4130 | 2020-10-28 |
| 1346849197 | Alexander F Talarico | Nurse Practitioner | 576 Broad St, Emmaus, PA 18049-3856 | 2020-10-22 |
| 1255930129 | Patrick A Foster | Nurse Practitioner | 3332 Eisenbrown Rd, Reading, PA 19605-1412 | 2020-10-22 |
| 1033718051 | Charlene Martin Wolfgang | Nurse Practitioner | 806 Megan Dr, Cranberry Twp, PA 16066-7422 | 2020-10-21 |
| 1750980728 | Jamie Simpson | Nurse Practitioner | 618 Rachelle Ct, Latrobe, PA 15650-4731 | 2020-10-21 |
| 1124627138 | Ashley G Dillard | Nurse Practitioner | 5447 Stanton Ave, Pittsburgh, PA 15206-2518 | 2020-10-21 |
| 1831798867 | Elena Khlobystova | Nurse Practitioner | 16 Carriage House Dr, Southampton, PA 18966-2225 | 2020-10-21 |
| Find all providers with the same taxonomy | ||||
| City | WILLOW GROVE |
| Zip Code | 19090 |
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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.