Wagner, Kimberly H
Wagner, Kimberly H is an individual health care provider with primary practice located at 125 W Interstate 30 , Royse City TX 75189-7512. 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, Kimberly H can be contacted via phone (903) 408-7700.Contact Information
Primary practice address
125 W Interstate 30
Royse City TX 75189-7512
Phone: (903) 408-7700
Fax: (903) 408-7810
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | RN 603948 | Texas |
Profile Details
| NPI number | 1164691465 |
|---|---|
| LBN Legal business name | Wagner, Kimberly H |
| Credentials | R.N., F.N.P |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 21st, 2008 |
| Last updated | Jun 4th, 2012 - about 14 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 | 1164691465 | NPPES |
| Texas | MEDICAID | 220100601 | |
| Texas | Other | 603948 |
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