Wagner, Deborah A

Wagner, Deborah A is an individual health care provider with primary practice located at 1025 Marsh St , Mankato MN 56001-4752. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Wagner, Deborah A can be contacted via phone (507) 625-4032.

Contact Information

Primary practice address
1025 Marsh St Mankato MN 56001-4752
Phone: (507) 625-4032
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 140806 Minnesota
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 2099 Wisconsin

Profile Details

NPI number 1699802181
LBN Legal business name Wagner, Deborah A
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 28th, 2007
Last updated Jul 14th, 2022 - about 3 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 1699802181 NPPES
Wisconsin MEDICAID 41936300

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