Wagner, Ernestine A
Wagner, Ernestine A is an sole proprietor health care provider with primary practice located at 2417 Post Road Building A, Stevens Point WI 54481. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Medical, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Medical is her primary health care specialty. Wagner, Ernestine A can be contacted via phone (715) 690-1272.Contact Information
Primary practice address
2417 Post Road Building A
Stevens Point WI 54481
Phone: (715) 690-1272
Fax: (715) 544-1212
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Medical | 363AM0700X | 1289-23 | Wisconsin |
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 978 | West Virginia |
| Physician Assistants & Advanced Practice Nursing Providers / Medical | 363AM0700X | 0110001577 | Virginia |
Profile Details
| NPI number | 1124072889 |
|---|---|
| LBN Legal business name | Wagner, Ernestine A |
| Credentials | Physician Assistant (PA) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 19th, 2006 |
| Last updated | Jun 2nd, 2015 - about 10 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 | 1124072889 | NPPES |
| West Virginia | Other | 001836169 | BLUE CROSS BLUE SHIELD |
| West Virginia | Other | 3001613 | BLUE CROSS BLUE SHIELD |
| West Virginia | MEDICAID | 10319951 | BLUE CROSS BLUE SHIELD |
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