Wagner, Jacquelyn Christine
Wagner, Jacquelyn Christine is an individual health care provider with primary practice located at 501 S Santa Fe Ave Suite 100, Salina KS 67401-4189. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Hospitalist. Allopathic & Osteopathic Physicians / Pediatrics is her primary health care specialty. Wagner, Jacquelyn Christine can be contacted via phone (785) 825-2273.Contact Information
Primary practice address
501 S Santa Fe Ave Suite 100
Salina KS 67401-4189
Phone: (785) 825-2273
Fax: (785) 825-2275
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | R77391 | Arizona |
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 0446272 | Kansas |
| Allopathic & Osteopathic Physicians / Hospitalist | 208M00000X | 04-46272 | Kansas |
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 04-46272 | Kansas |
Profile Details
| NPI number | 1235793100 |
|---|---|
| LBN Legal business name | Wagner, Jacquelyn Christine |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 26th, 2019 |
| Last updated | Sep 8th, 2022 - about 4 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 | 1235793100 | NPPES |
| Kansas | MEDICAID | 30004822670001 |
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