KRISTIN WAGNER (NPI# 1952743924) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952743924 |
| Entity Type | Individual |
| Full Name | KRISTIN WAGNER |
| Credential | P.A. |
| Practice Address |
2200 W. Eau Gallie Blvd. Suite 202c Melbourne FL 32935-3166 |
| Practice Telephone | 3217282722 |
| Practice Fax Number | 3214353652 |
| Mailing Telephone | 3217282722 |
| Mailing Fax Number | 3214353652 |
| Enumeration Date | 2013-07-19 |
| Last Update Date | 2014-06-26 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA9106405 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205105624 | Kristin Diane Wagner | Nurse Practitioner | 915 W Maple, Columbus, KS 66725 | 2011-12-14 |
| 1457654808 | Kristin M Wagner | Counselor | 1461 Hickory Ct, Erie, CO 80516-7986 | 2010-12-07 |
| 1558903468 | Kristin Wagner | Social Worker | 10630 Little Patuxent Pkwy Ste 209, Columbia, MD 21044-6278 | 2019-10-11 |
| 1518440890 | Kristin Nicole Wagner | Social Worker | 2021 Saint Marys Ave, Omaha, NE 68102-2415 | 2018-09-12 |
| 1205316676 | Kristin Wagner | Speech-Language Pathologist | 2499 Zerbe Rd, Narvon, PA 17555-9328 | 2018-08-15 |
| 1528480274 | Kristin Behrens Wagner | Counselor | 940 E Haverford Rd, Suite 102, Bryn Mawr, PA 19010-3845 | 2014-01-15 |
| 1053674945 | Kristin L Wagner | Nurse Practitioner | 1729 Burrstone Rd, New Hartford, NY 13413-1001 | 2012-06-17 |
| 1992096812 | Kristin St. Laurent Wagner | Counselor | 225 N 23rd St, Billings, MT 59101-2223 | 2011-04-26 |
| 1063699056 | Kristin Michelle Wagner | Social Worker | 2540 Charleston St, Oakland, CA 94602-2508 | 2008-01-22 |
| 1992879092 | Kristin Jo Wagner | Pharmacist | 3919 N Maple St, Spokane, WA 99205-1349 | 2006-11-20 |
| Street Address |
2200 W. EAU GALLIE BLVD. SUITE 202C |
| City | MELBOURNE |
| State | FL |
| Zip Code | 32935-3166 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407412018 | Aleecia Estime | Nurse Practitioner | 401 N Wickham Rd Ste S, Melbourne, FL 32935 | 2019-05-20 |
| 1669948261 | Lisa Marie Sarkees | Social Worker | 1503 Spring Drive, Melbourne, FL 32935 | 2018-10-22 |
| 1407355399 | Eugene Slaughter | Case Manager/Care Coordinator | 1600 W Eau Gallie Blvd. Suite 201 F, Melbourne, FL 32935 | 2018-02-06 |
| 1588173173 | Gregory M Mcdermand | Respiratory Therapist, Certified | 2745 Revolution St, Unit 101, Melbourne, FL 32935 | 2017-09-26 |
| 1386173649 | M Shami | Nurse Practitioner | 401 N Wickham Rd. Suite S, Melbourne, FL 32935 | 2017-06-08 |
| 1588102297 | Chiro Choice A Limited Liability Company | Clinic/Center | 1310 W Eau Galle Blvd Ste A, Melbourne, FL 32935 | 2017-02-02 |
| 1124574835 | A Loving Touch Private Home Care | Home Health | 1595 Palmwood Drive, Melbourne, FL 32935 | 2016-09-01 |
| 1538616099 | Pedro Triana Villamil | Specialist/Technologist, Other | 1600 Sarno Rd. Suite 15, Melbourne, FL 32935 | 2016-09-01 |
| 1528424132 | Lisa Forsythe | Acupuncturist | 1250 W. Eau Gallie Blvd., Suite H, Melbourne, FL 32935 | 2016-01-12 |
| 1528432028 | Harbor City Pharmacy Inc | Pharmacy | 503 Harbor City Blvd., Melbourne, FL 32935 | 2015-11-20 |
| Find all providers in zip 32935 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164021895 | Breeyon Beachel | Physician Assistant | 4610 Beck Lake Trl Apt 1, Melbourne, FL 32901-8805 | 2020-10-23 |
| 1215535257 | Melissa Lee Amos | Physician Assistant | 3543 Providence Trace Dr, Melbourne, KY 41059-9203 | 2020-10-12 |
| 1720694326 | Michelle Smith | Physician Assistant | 2330 Andrea Ct, Melbourne, FL 32934-7601 | 2020-09-18 |
| 1093331787 | Alyssa Capawana | Physician Assistant | 6740 Shadow Creek Trl Apt 5410, Melbourne, FL 32940-6293 | 2020-06-18 |
| 1194359018 | Jarrod D Kearney | Physician Assistant | 580 N Wickham Rd Ste C, Melbourne, FL 32935-8400 | 2020-02-29 |
| 1104392851 | Rachel Margaret Martins | Physician Assistant | 1052 Fieldstone Dr, Melbourne, FL 32940-1633 | 2018-10-21 |
| 1497230320 | Mirabella M. Muller | Physician Assistant | 298 Michigan Ave Ste 101, Melbourne, FL 32901-3104 | 2018-09-26 |
| 1538485941 | David Luke Brightwell | Physician Assistant | 54 Tate Springs Rd, Melbourne, AR 72556-8633 | 2010-04-09 |
| 1679808588 | Maycie A Cruz | Physician Assistant | Family Practice of Suntree and Viera, 2 Suntree Place, Melbourne, FL 32940 | 2009-10-09 |
| 1245467828 | Tony Ray Potter | Physician Assistant | 400 Sheridan Rd, Melbourne, FL 32901-3184 | 2009-06-22 |
| Find all providers in MELBOURNE | ||||
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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.