Wagner, Melissa Dalton

Wagner, Melissa Dalton is an sole proprietor health care provider with primary practice located at 125 S Main Cross St , Louisa KY 41230-1065. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Wagner, Melissa Dalton can be contacted via phone (606) 638-0938.

Contact Information

Primary practice address
125 S Main Cross St Louisa KY 41230-1065
Phone: (606) 638-0938
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 3009798 Kentucky

Profile Details

NPI number 1174992382
LBN Legal business name Wagner, Melissa Dalton
Credentials Advanced Practice Registered Nurse (APRN)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 17th, 2015
Last updated Mar 20th, 2024 - about 8 months 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 1174992382 NPPES
Kentucky Other 3009798 APRN LICENSE NUMBER
Kentucky MEDICAID 7100385910 APRN LICENSE NUMBER
Kentucky Other F0915844 APRN LICENSE NUMBER

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