MICHELLE WAGNER-SMITH (NPI# 1568858793) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568858793 |
| Entity Type | Individual |
| Full Name | MICHELLE WAGNER-SMITH |
| Credential | MSN, AGPCNP-BC |
| Practice Address |
John D. Dingell Vamc 4646 John R Street Detroit MI 48201-1916 |
| Mailing Address |
5780 Stewart Rd Monroe MI 48162-9700 |
| Practice Telephone | 3135764645 |
| Mailing Telephone | 7349156265 |
| Enumeration Date | 2015-04-14 |
| Last Update Date | 2015-04-15 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
4704204786 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LG0600X |
Nurse Practitioner Specialization: Gerontology |
4704204786 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
4704204786 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
JOHN D. DINGELL VAMC 4646 JOHN R STREET |
| City | DETROIT |
| State | MI |
| Zip Code | 48201-1916 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659989838 | Saima Sharif | Student in an Organized Health Care Education/Training Program | 4201 St Antoine St 9c-uhc Detroit Education & Research, Detroit, MI 48201 | 2020-07-14 |
| 1609494384 | Praveen Kumar Boddu | Student in an Organized Health Care Education/Training Program | 3901,beaubien, Ste 3t72, Children's Hospital, Detroit, MI 48201 | 2020-07-09 |
| 1730707720 | Amr Hassan Abdelghaffar Omar | Pediatrics | 3901 Beaubien St Room 3t72, Children's Hospital of Michigan, Detroit, MI 48201 | 2020-07-07 |
| 1700400694 | Hassan Imtiaz | Student in an Organized Health Care Education/Training Program | 4201 St. Antoine 8c-uhc, Detroit Medical Center, Detroit, MI 48201 | 2020-06-05 |
| 1598389074 | Alaa Awad Elkarim | Student in an Organized Health Care Education/Training Program | 3901 Beaubien St. 3t72, Detroit, MI 48201 | 2020-06-01 |
| 1891319299 | Jeongyeon Hwang | Student in an Organized Health Care Education/Training Program | 4201 St Antoine Street University Health Center - 8c, Detroit, MI 48201 | 2020-06-01 |
| 1477176576 | Jaudat Fatima Masood | Student in an Organized Health Care Education/Training Program | 4201 St Antoine Street, University Health Center - 8c, Detroit, MI 48201 | 2020-05-22 |
| 1205459419 | Amit Kumar Dahiya | Student in an Organized Health Care Education/Training Program | 11201 St. Antoine, Room 2e Uhc, Detroit, MI 48201 | 2020-05-21 |
| 1851914188 | Asra Nausheen Shaik | Student in an Organized Health Care Education/Training Program | 4201 St. Antoine St, Room 2e-uhc, Detroit, MI 48201 | 2020-05-21 |
| 1568085751 | Camille Olechowski | Student in an Organized Health Care Education/Training Program | 3901 Chrysler Dr. Detroit Medical Center, Room 5-a 538.1, Detroit, MI 48201 | 2020-05-21 |
| Find all providers in zip 48201 | ||||
| Taxonomy Code | 363LP2300X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750808648 | Mattie B. Johnson | Nurse Practitioner | 13599 Virgil St, Detroit, MI 48223-3050 | 2017-08-23 |
| 1184176984 | Amanda Marie Allmacher | Nurse Practitioner | 50 E Canfield St Ste 101-s, Detroit, MI 48201-1804 | 2016-10-27 |
| 1144774472 | Angela Jayne Wolf | Nurse Practitioner | 7409 2nd Ave, Apt. A2, Detroit, MI 48202-2700 | 2016-08-03 |
| 1912263914 | Tonia Anitra Willis | Nurse Practitioner | 14102 Saint Marys St, Detroit, MI 48227 | 2012-04-04 |
| 1861624058 | Angela Faye Woodley-williams | Nurse Practitioner | 11260 E Jefferson Ave, Detroit, MI 48214-3320 | 2009-08-20 |
| 1740394055 | Mary Patricia Lange | Nurse Practitioner | 4601 John R, Detroit, MI 48201 | 2006-08-17 |
| 1346848827 | Tanya L Locke | Nurse Practitioner | 22101 Moross Rd, Detroit, MI 48236-2148 | 2020-10-15 |
| 1720621279 | Rachel Campbell | Nurse Practitioner | 5716 Michigan Ave, Detroit, MI 48210-3039 | 2019-10-28 |
| 1124679188 | Shanta Nicole Brown | Nurse Practitioner | 16181 Hubbell St, Detroit, MI 48235-4026 | 2019-09-21 |
| 1851866396 | Christopher Childers | Nurse Practitioner | 4160 John R St Ste 930, Detroit, MI 48201-2017 | 2018-10-11 |
| Find all providers in DETROIT | ||||
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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.