LAURA KATHERINE WAGNER (NPI# 1679076285) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679076285 |
| Entity Type | Individual |
| Full Name | LAURA KATHERINE WAGNER |
| Credential | PA |
| Practice Address |
1222 S Orange Ave Orlando FL 32806-1215 |
| Practice Telephone | 4074237777 |
| Practice Fax Number | 4074231380 |
| Mailing Telephone | 4074237777 |
| Mailing Fax Number | 4074231380 |
| Enumeration Date | 2018-03-10 |
| Last Update Date | 2018-04-23 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | 9111160 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
PA9111160 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 024256600 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1222 S Orange Ave, Orlando, FL 328061215 | 4076496878 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518216332 | Laura Beth Wagner | Physician Assistant | 14 Deerwood Dr, Clark, NJ 07066-2817 | 2012-09-07 |
| 1679877302 | Laura Ann Wagner | Specialist | 8129 Wheeler Dr, Orland Park, IL 60462-4928 | 2011-01-10 |
| 1336441765 | Laura Wagner | Nurse Practitioner | 1700 Cooper Point Road Sw, Ste C-4, Olympia, WA 98502 | 2010-11-17 |
| 1356555742 | Laura L. Wagner | Nurse Practitioner | 2810 Crossroads Dr, Madison, WI 53718-7942 | 2007-05-09 |
| 1033269329 | Laura J Wagner | Social Worker | 1100 Cesery Blvd Ste 11, Jacksonville, FL 32211-5656 | 2007-01-11 |
| 1710507223 | Laura Michelle Wagner | Nurse Practitioner | 2 Koret Way # N-319x, San Francisco, CA 94143-2218 | 2020-04-24 |
| 1700423258 | Laura Ann Wagner | Behavior Technician | 7220 W Jefferson Ave Ste 202, Lakewood, CO 80235-2023 | 2019-12-03 |
| 1255891578 | Laura Lynn Wagner | Pharmacist | 744 Hwy 270 East, Mount Ida, AR 71957 | 2019-03-22 |
| 1679079719 | Laura Ann Wagner | Clinical Exercise Physiologist | 3525 E Louise Dr Ste 500, Meridian, ID 83642-6305 | 2018-04-05 |
| 1720586936 | Laura Lee Wagner | Counselor | 601 Stadium Mall Dr, West Lafayette, IN 47907-2052 | 2018-01-23 |
| Street Address |
1222 S ORANGE AVE |
| City | ORLANDO |
| State | FL |
| Zip Code | 32806-1215 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376546986 | Steven J Hoff | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1222 S Orange Ave, Orlando, FL 32806-1215 | 2005-05-27 |
| 1639793623 | Mikayla Alexis Ruane | Physician Assistant | 1222 S Orange Ave, Orlando, FL 32806-1215 | 2020-06-04 |
| 1699308536 | Bethany Kelley | Nurse Practitioner | 1222 S Orange Ave, Orlando, FL 32806-1215 | 2020-02-19 |
| 1194364620 | Cody Albert Pigon | Nurse Practitioner | 1222 S Orange Ave, Orlando, FL 32806-1215 | 2020-01-01 |
| 1528600442 | Jennie K Ayers | Physician Assistant | 1222 S Orange Ave, Orlando, FL 32806-1215 | 2019-10-11 |
| 1376193458 | David Estalilla | Physician Assistant | 1222 S Orange Ave, Orlando, FL 32806-1215 | 2019-09-19 |
| 1437709664 | Brannen Allen Davis | Physician Assistant | 1222 S Orange Ave, Orlando, FL 32806-1215 | 2019-09-19 |
| 1386294098 | Heidi Lyn Seymour | Physician Assistant | 1222 S Orange Ave, Orlando, FL 32806-1215 | 2019-09-14 |
| 1437703592 | Paige Salerno | Physician Assistant | 1222 S Orange Ave, Orlando, FL 32806-1215 | 2019-07-27 |
| 1174175285 | Amanda Kay Graham | Registered Nurse | 1222 S Orange Ave, Orlando, FL 32806-1215 | 2019-07-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710585674 | Erika Williams | Pharmacist | 2715 South Orlando Ave, Orlando, FL 32806 | 2020-10-13 |
| 1013545664 | Johanna Yadira Cook | Registered Nurse | Orlando Health Orlando Regional Medical Center, 52 W. Underwood St, Orlando, FL 32806 | 2020-03-30 |
| 1396372306 | Warren Andrew Williams | Student in an Organized Health Care Education/Training Program | 1222 S. Orange Ave., 5th Fl, Mp# 43, Orlando, FL 32806 | 2020-03-27 |
| 1225665433 | Astrid Helen Casin | Student in an Organized Health Care Education/Training Program | 1222 S. Orange Avenue, 5th Fl., Mp#43, Orland, FL 32806 | 2020-03-26 |
| 1508404211 | Hidden Potential Florida LLC | Assistant Behavior Analyst | 2857 South Bumby Avenue, Orlando, FL 32806 | 2019-12-12 |
| 1720639883 | Cynthia Lee Kling | Clinical Nurse Specialist | Arnold Palmer Hospital, 92 W. Miller St., Orlando, FL 32806 | 2019-09-20 |
| 1033769930 | Darleen Ann Williams | Clinical Nurse Specialist | 52 W. Underwood, Orlando, FL 32806 | 2019-09-13 |
| 1508412644 | Trischaday Kimberley Demetrius | Nurse Practitioner | Orlando Epilepsy Center, 226 W Michigan Street, Orlando, FL 32806 | 2019-08-14 |
| 1962964809 | Ajc Software Inc | Prosthetic/Orthotic Supplier | 1405 South Orange Avenue Suite 308, Orlando, FL 32806 | 2019-04-01 |
| 1598232852 | Sodo Smiles Dentistry, Pa | Dentist | 3123 S. Orange Ave., Suite 107, Orlando, FL 32806 | 2018-10-25 |
| Find all providers in zip 32806 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811559578 | Sydney Gillen | Physician Assistant | 1222 S Orange Ave Fl 2, Orlando, FL 32806-1215 | 2019-07-02 |
| 1750843405 | Heather Louise Anderson | Physician Assistant | 5422 Lewiston St, Orlando, FL 32812 | 2019-04-02 |
| 1649600891 | Raul F Velez | Physician Assistant | 14139 Budworth Cir, Orlando, FL 32832-6123 | 2013-11-24 |
| 1255630075 | Joleen Chapman | Physician Assistant | 122 Annie St, Orlando, FL 32806-1214 | 2011-03-18 |
| 1124354600 | Tiffany M Murray | Physician Assistant | 83 W Copeland Dr, Orlando, FL 32806-2002 | 2009-10-19 |
| 1225277825 | M Catherine Broderick | Physician Assistant | 1720 S Cook Avenue, Orlando, FL 32808 | 2009-02-05 |
| 1033360938 | Monica M Rivera | Physician Assistant | 2591 Carrickton Cir, Orlando, FL 32824-4217 | 2008-10-09 |
| 1316104383 | Michele D Young | Physician Assistant | 3802 Oakwater Cir Ste 3, Orlando, FL 32806-6200 | 2008-05-19 |
| 1033162011 | Southeastern Clinical Services,inc. | Physician Assistant | 4215 Edgewater, Orlando, FL 32804 | 2006-05-18 |
| 1386696631 | Kevin P Kingsley | Physician Assistant | 2501 N Orange Ave Ste 411, Orlando, FL 32804-4644 | 2006-05-16 |
| Find all providers in ORLANDO | ||||
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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.