Wagner, Casey Rae

Wagner, Casey Rae is an individual health care provider with primary practice located at 5325 Faraon St. , St. Joseph MO 64506-3488. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Obstetrics & Gynecology, which is considered as her primary health care specialty. Wagner, Casey Rae can be contacted via phone (816) 271-6000.

Contact Information

Primary practice address
5325 Faraon St. St. Joseph MO 64506-3488
Phone: (816) 271-6000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Obstetrics & Gynecology 363LX0001X 2011028689 Missouri
Physician Assistants & Advanced Practice Nursing Providers / Obstetrics & Gynecology 363LX0001X 75395 Kansas

Profile Details

NPI number 1750659777
LBN Legal business name Wagner, Casey Rae
Credentials Advanced Practice Registered Nurse (APRN)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 5th, 2011
Last updated Oct 30th, 2017 - about 7 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 1750659777 NPPES
Missouri MEDICAID 1750659777
Missouri MEDICAID 200750820A

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