Wagner, Traci Lee

Wagner, Traci Lee is an individual health care provider with primary practice located at 580 St. Johnsbury Rd. , Littleton NH 03561. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Wagner, Traci Lee can be contacted via phone (603) 444-7070.

Contact Information

Primary practice address
580 St. Johnsbury Rd. Littleton NH 03561
Phone: (603) 444-7070
Fax: (603) 788-5027
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 12859 New Hampshire

Profile Details

NPI number 1932187465
LBN Legal business name Wagner, Traci Lee
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 5th, 2006
Last updated Apr 11th, 2017 - about 9 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 1932187465 NPPES
New Hampshire MEDICAID 30205431
New Hampshire MEDICAID 1011825

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