Wagner, Betty J

Wagner, Betty J is an individual health care provider with primary practice located at 6910 Hillsdale Ct , Indianapolis IN 46250-2040. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Primary Care, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is her primary health care specialty. Wagner, Betty J can be contacted via phone (317) 841-6552.

Contact Information

Primary practice address
6910 Hillsdale Ct Indianapolis IN 46250-2040
Phone: (317) 841-6552
Fax: (317) 841-6160
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Primary Care 363LP2300X 71000881A Indiana
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 71000881A Indiana

Profile Details

NPI number 1619997731
LBN Legal business name Wagner, Betty J
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 20th, 2006
Last updated Jun 14th, 2017 - about 8 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 1619997731 NPPES
Indiana MEDICAID 200944340

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