MISS SOPHIA JANE WAGNER (NPI# 1972026276) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972026276 |
| Entity Type | Individual |
| Full Name | MISS SOPHIA JANE WAGNER |
| Credential | PA-C |
| Practice Address |
2643 Patterson Rd Ste 403 Grand Junction CO 81506-1937 |
| Mailing Address |
2643 Patterson Rd #403 Grand Junction CO 81506-1937 |
| Practice Telephone | 9702987675 |
| Mailing Telephone | (970) 298-7675 |
| Mailing Fax Number | 9702982984 |
| Enumeration Date | 2017-07-19 |
| Last Update Date | 2017-08-22 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
2643 PATTERSON RD STE 403 |
| City | GRAND JUNCTION |
| State | CO |
| Zip Code | 81506-1937 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255944534 | Scl Health Medical Group - Grand Junction, LLC | Clinic/Center | 2643 Patterson Rd Ste 403, Grand Junction, CO 81506-1937 | 2020-08-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235759820 | Dana Patton | Student in an Organized Health Care Education/Training Program | St. Mary's Family Medicine Center, 2698 Patterson Road, Grand Junction, CO 81506 | 2020-04-23 |
| 1720646292 | Creed Ott | Family Medicine | 2698 Patterson Road, Grand Junction, CO 81506 | 2019-05-30 |
| 1568948776 | Lakeside Psychological Services, LLC | Clinic/Center | 3154 Lakeside Dr Apt 103, Grand Junction, CO 81506 | 2018-07-11 |
| 1700389095 | Catherine Martha Plough | Registered Nurse | 2754 Compass Drive, Suite 377, Grand Junction, CO 81506 | 2018-03-13 |
| 1114445657 | Katrina Nicol Metcalf | Nurse Practitioner | 2643 Patterson Road Suite 605, Grand Junction, CO 81506 | 2017-09-05 |
| 1346760642 | Christopher Lewis Hoef II | Licensed Practical Nurse | 3031 N 14th St, Grand Junction, CO 81506 | 2017-06-27 |
| 1477928976 | Welbrook Senior Living Grand Junction LLC | Skilled Nursing Facility | 2596 Patterson Rd., Grand Junction, CO 81506 | 2015-12-09 |
| 1073902284 | Brett Adams | Audiologist-Hearing Aid Fitter | 2643 Patterson Rd Ste 503, Grand Junction, CO 81506 | 2015-01-12 |
| 1942625116 | Pamela W Kreps | Hearing Instrument Specialist | 759 Horizon Dr Ste E, Grand Junction, CO 81506 | 2014-02-25 |
| 1962779249 | Premere Rehab LLC | Occupational Therapist | 625 271/2 Road, Grand Junction, CO 81506 | 2011-11-30 |
| Find all providers in zip 81506 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275527335 | Daryl T. Haan | Physician Assistant | 627 25 1/2 Road, Grand Junction, CO 81505-6401 | 2005-09-06 |
| 1881245371 | Danielle Vesth | Physician Assistant | 2643 Patterson Rd Ste 401, Grand Junction, CO 81506-1937 | 2019-09-25 |
| 1356809941 | Megan Dighero | Physician Assistant | 2440 N 11th St, Grand Junction, CO 81501-8102 | 2019-03-04 |
| 1437634094 | Gabriel Deleon | Physician Assistant | 2373 G Rd Ste 280, Grand Junction, CO 81505-1006 | 2018-09-30 |
| 1669915088 | Dallin Davies | Physician Assistant | 2440 N 11th St, Grand Junction, CO 81501-8102 | 2016-12-03 |
| 1730437617 | Jason B Bell | Physician Assistant | 2373 G Rd, Suite 100, Grand Junction, CO 81505-9641 | 2012-08-26 |
| 1538459847 | Laken Renee Eyler | Physician Assistant | 627 25 1/2 Rd, Grand Junction, CO 81505-6401 | 2011-04-08 |
| 1063645992 | Elizabeth Moyle Carlson | Physician Assistant | 735 White Ave, Grand Junction, CO 81501-3441 | 2009-08-26 |
| 1891886503 | Gary Lee Blunk | Physician Assistant | 2373 G Rd, Suite 200, Grand Junction, CO 81505-9641 | 2006-09-27 |
| 1851498331 | Todd David Ousley | Physician Assistant | 627 25 1/2 Rd, Grand Junction, CO 81505-6401 | 2006-09-19 |
| Find all providers in GRAND JUNCTION | ||||
| City | GRAND JUNCTION |
| Zip Code | 81506 |
Please comment or provide details below to improve the information on MISS SOPHIA JANE WAGNER.
| 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.