Debra Lynn Wagner, CNM, ARNP

Primary specialty

Advanced Practice MidwifeTaxonomy code 367A00000X

License

ARNP1422352 Issued in FL

Practice address

2080 Child St
Jacksonville, FL 32214-5005

Phone

(904) 542-7300

NPI assigned

Feb 15, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Certified Nurse Midwife

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1013050095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12031 MORNING STAR CT",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322461376",
            "telephone_number": "904-998-2066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2080 CHILD ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322145005",
            "telephone_number": "904-542-7300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "DEBRA",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "CNM, ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "FL",
            "license": "ARNP1422352",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie N Waggoner, LMHC
• Sujata M Wagh, MD
• Alexis Wagner, OTR/L
• Bryan J Wagner, OT, ATC, LAT
• Christy Wagner, APRN
• Elaine C. Wagner, D.D.S.
• Ellen Rogers Wagner, OD
• Kendra Anne Wagner, LMHC
• Kyle Wagner, DPT
• Laura J Wagner, LCSW

• Advanced Practice Midwife in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Advanced Practice Midwife in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.