Wagner, Laurie A
Wagner, Laurie A is an individual health care provider with primary practice located at 4401 Masthead St Ne Suite 120, Albuquerque NM 87109-4493. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as her primary health care specialty. Wagner, Laurie A can be contacted via phone (505) 243-7729.Contact Information
Primary practice address
4401 Masthead St Ne Suite 120
Albuquerque NM 87109-4493
Phone: (505) 243-7729
Fax: (505) 243-4804
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered | 367500000X | R32370 | New Mexico |
Profile Details
| NPI number | 1063480879 |
|---|---|
| LBN Legal business name | Wagner, Laurie A |
| Credentials | Certified Registered Nurse Anesthetist (CRNA) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 8th, 2006 |
| Last updated | Jul 2nd, 2013 - about 11 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 | 1063480879 | NPPES |
| New Mexico | MEDICAID | Q6459 |
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