Wagner, Crystal

Wagner, Crystal is an individual health care provider with primary practice located at 85 N Grand Ave , Fort Thomas KY 41075-1793. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Wagner, Crystal can be contacted via phone (859) 572-3617.

Contact Information

Primary practice address
85 N Grand Ave Fort Thomas KY 41075-1793
Phone: (859) 572-3617
Fax: (859) 572-2326
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 3009831 Kentucky

Profile Details

NPI number 1689049033
LBN Legal business name Wagner, Crystal
Credentials Advanced Practice Registered Nurse (APRN)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 10th, 2015
Last updated Feb 19th, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1689049033 NPPES
Kentucky MEDICAID 7100411630
Kentucky MEDICAID 0229162

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