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KRISTEN M WAGNER D.O. NPI 1598017048


NPI Information

NPI: 1598017048
Provider Name: KRISTEN M WAGNER, D.O.
Classification: Family Medicine - 207Q00000X
Entity Type: Individual

PECOS Registration: Yes

Address:
3443 FARR RD
FRUITPORT, MI
ZIP 49415
Phone: (231) 672-2900
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Kristen M Wagner, D.O. is a family medicine in Fruitport, MI with 12 years of experience. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. Kristen M Wagner, D.O. NPI is 1598017048. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: UNIVERSITY OF NEW ENGLAND, COLLEGE OF OSTEO MEDICINE
Graduation Year:2012

The provider's business location address is:

3443 FARR RD
FRUITPORT, MI
ZIP 49415-779
Phone: (231) 672-2900
Fax: (231) 672-2901

The NPI 1598017048 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 10/9/2012 and was last updated on 12/23/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily Medicine5101020125MICHIGANYes
2207V00000XObstetrics & Gynecology5101020125MICHIGANNo

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.