MRS. REBEKAH MARIE WAGONER (NPI# 1770130437) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770130437 |
| Entity Type | Individual |
| Full Name | MRS. REBEKAH MARIE WAGONER |
| Credential | APRN, FNP-C |
| Practice Address |
617 Russell Blvd Nacogdoches TX 75965-1247 |
| Practice Telephone | 9363055109 |
| Practice Fax Number | 9363055112 |
| Mailing Telephone | 9367155353 |
| Enumeration Date | 2019-08-19 |
| Last Update Date | 2019-08-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
AP142101 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
617 RUSSELL BLVD |
| City | NACOGDOCHES |
| State | TX |
| Zip Code | 75965-1247 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407084114 | Rachel B Head | Urology | 617 Russell Blvd, Nacogdoches, TX 75965-1247 | 2009-07-01 |
| 1891028395 | Advanced Surgical Associates of East Texas | Surgery | 617 Russell Blvd, Nacogdoches, TX 75965-1247 | 2009-09-15 |
| 1538492038 | Colon & Rectal Clinic of East Texas | Colon & Rectal Surgery | 617 Russell Blvd, Nacogdoches, TX 75965-1247 | 2009-09-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649839135 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 3824 N University Drive, Suite 103, Nacogdoches, TX 75965 | 2019-06-10 |
| 1518520493 | Billy Jobe | Pharmacist | 917 East Austin, Nacogdoches, TX 75965 | 2019-04-17 |
| 1295217610 | Sarah Ponder | Registered Nurse | 625 Woodway Lane, Nacogdoches, TX 75965 | 2018-09-01 |
| 1083107684 | Aakash Deep Gupta | Dentist | 4610 North St Ste 101b, Nacogdoches, TX 75965 | 2018-06-08 |
| 1679097455 | Emily Morris Taravella | Counselor | 3524 Ne Stallings Drive, Nacogdoches, TX 75965 | 2017-08-02 |
| 1457809949 | Kassey Osborn | Nurse Practitioner | 4920 Ne Stallings Dr., Nacogdoches Medical Center, Nacogdoches, TX 75965 | 2016-09-14 |
| 1629426747 | Lisa Greathouse | Technician, Other | 500 Chincapin, Westville, OK 75965 | 2016-05-31 |
| 1457741704 | Nuch of Texas | Pediatrics | 1305 North Street, Nacogdoches, TX 75965 | 2015-01-26 |
| 1730506031 | Benjamin Patrick Thompson | Obstetrics & Gynecology | 4800 Ne Stallings Dr Ste 106, Nacogdoches, TX 75965 | 2014-03-25 |
| 1255761813 | Kallie Krawietz | Counselor | 2214 N Pecan Street, Nacogdoches, TX 75965 | 2013-11-19 |
| Find all providers in zip 75965 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861009540 | Latrice Jeannette Berry | Nurse Practitioner | 330 W College St, Nacogdoches, TX 75965-3911 | 2020-09-28 |
| 1598397515 | Jessica Lauren Brown | Nurse Practitioner | 4106 Belle Pointe Dr, Nacogdoches, TX 75965-4879 | 2020-02-07 |
| 1477193779 | Emma Pruett | Nurse Practitioner | 757 County Road 2054, Nacogdoches, TX 75965-1063 | 2020-01-14 |
| 1881171353 | Lauren Homer | Nurse Practitioner | 115 County Road 9151, Nacogdoches, TX 75964-0272 | 2018-07-26 |
| 1598279788 | Tammye Willis | Nurse Practitioner | 1023 N Mound St Ste K, Nacogdoches, TX 75961-4453 | 2017-11-27 |
| 1972982866 | Deanna Ellen Bishop | Nurse Practitioner | 1309 S. University Dr, East Texas Community Health Services, Inc., Nacogdoches, TX 75961 | 2015-05-25 |
| 1922410828 | Brinson Stewart | Nurse Practitioner | 607 Russell Blvd Ste A, Nacogdoches, TX 75965-1247 | 2014-05-27 |
| 1871878835 | Peni Jean Russell | Nurse Practitioner | 283 County Road 264, Nacogdoches, TX 75965-0530 | 2011-10-20 |
| 1265767297 | Practitioners On The Go LLC | Nurse Practitioner | 942 Happy Land Rd, Nacogdoches, TX 75965-7827 | 2009-10-08 |
| 1215111778 | Carolyn Louise Patton | Nurse Practitioner | 1407 E Main St, Nacogdoches, TX 75961-5369 | 2007-12-19 |
| Find all providers in NACOGDOCHES | ||||
| City | NACOGDOCHES |
| Zip Code | 75965 |
Please comment or provide details below to improve the information on MRS. REBEKAH MARIE WAGONER.
| 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.