Wagner, Kimberly Lue

Wagner, Kimberly Lue is an individual health care provider with primary practice located at 2312 N Nevada Ave Suite 100, Colorado Springs CO 80907-5302. She recently has only one registered license in Allopathic & Osteopathic Physicians / Neurology, which is considered as her primary health care specialty. Wagner, Kimberly Lue can be contacted via phone (719) 473-3272.

Contact Information

Primary practice address
2312 N Nevada Ave Suite 100 Colorado Springs CO 80907-5302
Phone: (719) 473-3272
Fax: (719) 473-1191
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neurology 2084N0400X 53519 Colorado

Profile Details

NPI number 1922325497
LBN Legal business name Wagner, Kimberly Lue
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 23rd, 2010
Last updated Mar 22nd, 2017 - about 9 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 1922325497 NPPES
Colorado MEDICAID 03254356

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