Wagner, Donnelle I.
Wagner, Donnelle I. is an individual health care provider with primary practice located at 3700 Cliff Dr , Fort Smith AR 72903-5954. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Wagner, Donnelle I. can be contacted via phone (479) 709-7260.Contact Information
Primary practice address
3700 Cliff Dr
Fort Smith AR 72903-5954
Phone: (479) 709-7260
Fax: (479) 709-7261
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | ATP000123 | Arkansas |
Profile Details
| NPI number | 1225213812 |
|---|---|
| LBN Legal business name | Wagner, Donnelle I. |
| Credentials | DNP |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 2nd, 2008 |
| Last updated | Sep 22nd, 2015 - about 11 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1225213812 | NPPES |
| Arkansas | MEDICAID | 168334758 | |
| Arkansas | MEDICAID | 200130940A |
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