Wagner, Jennifer Kathleen

Wagner, Jennifer Kathleen is an individual health care provider with primary practice located at 2968 Rodeo Park Dr W Ste 150 , Santa Fe NM 87505-6383. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Orthopaedic Surgery, Allopathic & Osteopathic Physicians / Hand Surgery. Allopathic & Osteopathic Physicians / Hand Surgery is her primary health care specialty. Wagner, Jennifer Kathleen can be contacted via phone (505) 913-5227.

Contact Information

Primary practice address
2968 Rodeo Park Dr W Ste 150 Santa Fe NM 87505-6383
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X BP10030789 Texas
Allopathic & Osteopathic Physicians / Hand Surgery 207XS0106X R2248 Texas

Profile Details

NPI number 1356504674
LBN Legal business name Wagner, Jennifer Kathleen
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 7th, 2008
Last updated Mar 28th, 2024 - about last year

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 1356504674 NPPES
New Mexico MEDICAID 59076356

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