MS. MICHELLE DEAN WAGNER (NPI# 1528265956) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528265956 |
| Entity Type | Individual |
| Full Name | MS. MICHELLE DEAN WAGNER |
| Credential | M.S.,L.P.C., B.C.P.C |
| Practice Address |
833 Broadway St Suite 103 Cape Girardeau MO 63701-5515 |
| Mailing Address |
1806 Northbridge St Cape Girardeau MO 63701-2532 |
| Practice Telephone | 5733327889 |
| Practice Fax Number | 5733327889 |
| Mailing Telephone | 5733327889 |
| Mailing Fax Number | 5733327889 |
| Enumeration Date | 2007-06-29 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
2001012922 | MO | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 495017337 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578032066 | Michelle Wagner | Speech-Language Pathologist | 17732 Highland Rd Ste G254, Baton Rouge, LA 70810-3846 | 2018-11-14 |
| 1790265262 | Michelle Wagner | Registered Nurse | 4949 Liberty Ln Ste 210, Allentown, PA 18106-9063 | 2018-08-15 |
| 1326539180 | Michelle Diane Wagner | Student in an Organized Health Care Education/Training Program | 1250 E Marshall St # 980264, Richmond, VA 23298-5051 | 2018-05-28 |
| 1194276113 | Michelle Wagner | Registered Nurse | 401 Cypress St, Manchester, NH 03103 | 2016-10-14 |
| 1396123485 | Michelle Wagner | Dietitian, Registered | 900 E Broadway Ave, Bismarck, ND 58501-4520 | 2015-05-11 |
| 1689006181 | Michelle Lynn Wagner | Nurse Practitioner | 2142 N Cove Blvd, Toledo, OH 43606-3895 | 2013-08-07 |
| 1407101843 | Michelle Wagner | Behavioral Analyst | 9755 Lincoln Village Dr, Sacramento, CA 95827-3334 | 2012-07-23 |
| 1982984811 | Michelle Dillon Wagner | Speech-Language Pathologist | 17045 El Camino Real, Suite 106, Houston, TX 77058-2649 | 2011-08-23 |
| 1346566577 | Michelle Jayne Wagner | Family Medicine | 248 Mchenry St, Burlington, WI 53105-1828 | 2010-04-13 |
| 1831340850 | Michelle Wagner Iv | Physical Therapist | 21800 Chardon Rd, Euclid, OH 44117-2125 | 2008-10-08 |
| Street Address |
833 BROADWAY ST SUITE 103 |
| City | CAPE GIRARDEAU |
| State | MO |
| Zip Code | 63701-5515 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336748110 | Westbrook Dialysis, LLC | Clinic/Center | 140 West Drive, Cape Girardeau, MO 63701 | 2020-10-22 |
| 1972079580 | Savannah Laine Menard | Behavior Technician | 20 S. Sprigg St, Cape Girardeau, MO 63701 | 2018-10-22 |
| 1932690377 | Broadway Specialty, LLC | Pharmacy | 706 Broadway St, Cape Girardeau, MO 63701 | 2018-05-22 |
| 1356864649 | Terri L. Mccord | Pharmacist | 4170 Connor Dr, Cape Girardeau, MO 63701 | 2017-07-19 |
| 1013459312 | Christina Cossou | Nurse Practitioner | 2116 Megan Dr Ste 102, Cape Girardeau, MO 63701 | 2016-11-17 |
| 1124573365 | Ashley Sullivan | Massage Therapist | 3041 Melrose Ave, Cape Girardeau, MO 63701 | 2016-08-17 |
| 1225432172 | Axpm - Merkley, LLC | Dentist | 2116 Megan Dr., Suite 101, Cape Girardeau, MO 63701 | 2014-10-21 |
| 1639573397 | Marian Perez Hurt | Physical Therapist | 2001 N. Kingshighway, Fountainbleau Lodge, Cape Girardeau, MO 63701 | 2014-10-09 |
| 1891194213 | Deanna Abner | Case Manager/Care Coordinator | 20 South Sprigg, Cape Girardeau, MO 63701 | 2014-08-21 |
| 1831506880 | Kwadwo O Britwum | Behavioral Analyst | Morningstar Behavioral Associates, 338 W. Broadway Suite 301, Cape Girardeau, MO 63701 | 2014-07-22 |
| Find all providers in zip 63701 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073012217 | Dale & Associates | Counselor | 2846 Professional Ct, Cape Girardeau, MO 63703-5035 | 2018-02-02 |
| 1679939086 | Samuel Hite | Counselor | 1025 N. Sprigg, Cottonwood Residential Treatment Center, Cape Girardeau, MO 63701-4831 | 2016-01-14 |
| 1205246634 | John Coffee | Counselor | 2935 Lynwood Hills Dr, Cape Girardeau, MO 63701-8408 | 2014-05-07 |
| 1891137071 | Dale and Hancock Center LLC | Counselor | 528 Helena St, Cape Girardeau, MO 63701-5133 | 2013-07-29 |
| 1285932855 | Jennifer Lauren Nelson | Counselor | 1 University Plz # Ms 3333, Southeast Missouri State University, Cape Girardeau, MO 63701-4710 | 2011-03-07 |
| 1598909939 | Janice L Ruesler | Counselor | 340 S Broadview St, Cape Girardeau, MO 63703-5703 | 2009-04-29 |
| 1508036260 | Shawna R Legrand | Counselor | 402 S Silver Sprng Rd, Cape Girardeau, MO 63703-7536 | 2008-03-08 |
| 1750597514 | Felicia Kennedy | Counselor | 815 N Fountain St, Cape Girardeau, MO 63701-7201 | 2007-05-15 |
| 1659448785 | Beverly Gore Stott | Counselor | 2917 Park West Hts, Cape Girardeau, MO 63703-5005 | 2006-11-30 |
| 1053483198 | Betty Jean Prigge | Counselor | 324 William, 1f, Cape Girardeau, MO 63701 | 2006-11-14 |
| Find all providers in CAPE GIRARDEAU | ||||
| City | CAPE GIRARDEAU |
| Zip Code | 63701 |
Please comment or provide details below to improve the information on MS. MICHELLE DEAN 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.