Stacy L Wagner, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

RN276830L Issued in PA

Practice address

401 Broad St
Johnstown, PA 15906-2745

Phone

(814) 535-6000

Fax

(814) 248-7901

NPI assigned

Feb 7, 2023

Sex

Female

Sole proprietor

Yes

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

Registered Nurse

State licenses

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

{
    "created_epoch": "1675728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675728000000",
    "number": "1245936533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 160",
            "city": "WILMORE",
            "state": "PA",
            "postal_code": "159620160",
            "telephone_number": "814-915-0430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 BROAD ST",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "159062745",
            "telephone_number": "814-535-6000",
            "fax_number": "814-248-7901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "STACY",
        "middle_name": "L",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-02-07",
        "last_updated": "2023-02-07",
        "certification_date": "2023-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PA",
            "license": "RN276830L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Can Vuruskan, MD
• W a B Physical Medicine & Rehabilitation of Pennsylvania PC
• Lauren Wackerman, DO
• Lisa Jane Wadsworth
• Tamera Waggle, CRNA
• Susan Carol Wagner, LSW
• Wal-Mart Stores East , LP
• Wal-Mart Stores East, LP
• Bethany Walerysiak, CRNP
• Alexander Wales, DO

• Registered Nurse in Johnstown, PA
• Providers in Johnstown, PA by specialty
• Registered Nurse in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2023; 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.