DR. TRACIE DENIE JOHNSON-WAGNER (NPI# 1578064382) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578064382 |
| Entity Type | Individual |
| Full Name | DR. TRACIE DENIE JOHNSON-WAGNER |
| Credential | NURSE PRACTITIONER |
| Practice Address |
3864 N 27th Ave Phoenix AZ 85017-4703 |
| Mailing Address |
3559 115th St Pleasant Prairie WI 53158-5610 |
| Practice Telephone | 6026856000 |
| Mailing Telephone | 8478879346 |
| Enumeration Date | 2018-02-27 |
| Last Update Date | 2018-02-27 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
AP11024 | AZ | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
3864 N 27TH AVE |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85017-4703 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275503559 | Judith Ann Levin | Nurse Practitioner | 3864 N 27th Ave, Phoenix, AZ 85017-4703 | 2006-01-26 |
| 1255938973 | Kristen Jane Pyland | Pharmacist | 3864 N 27th Ave, Phoenix, AZ 85017-4703 | 2020-10-06 |
| 1366069072 | Vicki Robin Spahr | Counselor | 3864 N 27th Ave, Phoenix, AZ 85017-4703 | 2020-06-29 |
| 1912521477 | Chelsea Sneller | Social Worker | 3864 N 27th Ave, Phoenix, AZ 85017-4703 | 2020-06-01 |
| 1265068803 | Jessica Renee Jouas | Social Worker | 3864 N 27th Ave, Phoenix, AZ 85017-4703 | 2020-03-16 |
| 1093363368 | Melanie R Stasny | Counselor | 3864 N 27th Ave, Phoenix, AZ 85017-4703 | 2019-08-29 |
| 1801363114 | Terros Health | Clinic/Center | 3864 N 27th Ave, Phoenix, AZ 85017-4703 | 2018-10-25 |
| 1609367325 | Ijeoma P Ogbuchiekwe | Counselor | 3864 N 27th Ave, Phoenix, AZ 85017-4703 | 2018-05-29 |
| 1164919064 | Christine Queval-chung | Nurse Practitioner | 3864 N 27th Ave, Phoenix, AZ 85017-4703 | 2018-04-16 |
| 1114437092 | Michael Schember | Pharmacist | 3864 N 27th Ave, Phoenix, AZ 85017-4703 | 2017-10-05 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477169282 | Deborah Carter | Specialist/Technologist | 5346 N. 29th Ave., Phoenix, AZ 85017 | 2020-09-17 |
| 1730671207 | Michael Carl Smith | Assisted Living Facility | 5736 N 33rd Ave, Phoenix, AZ 85017 | 2018-05-31 |
| 1457860561 | Bianca Yvonne Lopez | Psychiatry & Neurology | 3001 N. 33rd Ave, Phoenix, AZ 85017 | 2017-09-21 |
| 1295259281 | Happy Home Care | Home Health | 4550 N. Black Canyon Hwy Road, Phoenix, AZ 85017 | 2017-08-01 |
| 1851848493 | Horeb Transportation LLC | Non-emergency Medical Transport (VAN) | 5718 N Black Canyon Hwy, 36, Phoenix, AZ 85017 | 2016-09-01 |
| 1932565942 | Urgent Pain, LLC | Contractor | 6025 N. 27th Ave, Suite 6, Phoenix, AZ 85017 | 2016-01-06 |
| 1457766172 | Lindsay Allison Love | Social Worker | 3306 W. Catalina Dr., Phoenix, AZ 85017 | 2014-06-23 |
| 1437592433 | Maya Medical Services | Clinic/Center | 2908 W. Camelback Rd., Phoenix, AZ 85017 | 2013-04-10 |
| 1801089685 | Jonnie Arnold | Counselor | 3400 Grand Ave, Phoenix, AZ 85017 | 2007-08-24 |
| 1851414890 | Corpus Christi Home Care and Hospice LLC | Hospice Care, Community Based | 3001 W Indian School Rd, Suite #26, Phoenix, AZ 85017 | 2007-04-06 |
| Find all providers in zip 85017 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215536479 | Yolanda D Baugh | Nurse Practitioner | 2625 W Piedmont Rd, Phoenix, AZ 85041-9540 | 2020-10-20 |
| 1306450960 | Williamsconsultant Com LLC | Nurse Practitioner | 2303 N 44th St Ste 12-1043, Phoenix, AZ 85008-2442 | 2020-09-01 |
| 1912515305 | Victory Health Solution LLC | Nurse Practitioner | 9132 W Hubbell St, Phoenix, AZ 85037-4377 | 2020-07-21 |
| 1700494374 | Vanessa Moe | Nurse Practitioner | 42949 N Voyage Trl, Phoenix, AZ 85086-8040 | 2020-07-20 |
| 1043838527 | Latasha Lynne Freeman | Nurse Practitioner | 1919 E Thomas Rd Bldg 5th, Phoenix, AZ 85016-7710 | 2020-07-10 |
| 1861019416 | Gayle Cecilia Bachelier | Nurse Practitioner | 2302 N Central Ave Unit 303, Phoenix, AZ 85004-1373 | 2020-06-30 |
| 1871119156 | Ashlyn Tellers | Nurse Practitioner | 21438 N 33rd Ave, Phoenix, AZ 85027-2241 | 2020-06-22 |
| 1770109605 | Hannah Carita Jurekovic-byrd | Nurse Practitioner | 5727 N 7th St Ste 308, Phoenix, AZ 85014-5817 | 2020-06-16 |
| 1578188025 | Joseph Medlin | Nurse Practitioner | 915 N 52nd St Apt 2010, Phoenix, AZ 85008-7934 | 2020-06-10 |
| 1750901088 | Foothills Psychiatric Services Pllc | Nurse Practitioner | 3546 E Windmere Dr, Phoenix, AZ 85048-7211 | 2020-04-16 |
| Find all providers in PHOENIX | ||||
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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.