Stella Wagner, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

L032957 Issued in AR

Practice address

110 Pearson
Benton, AR 72015-4436

Phone

(501) 315-4224

Fax

(501) 778-0450

NPI assigned

Dec 6, 2022

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

Other names 1

• Stella Hood Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1670284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670284800000",
    "number": "1285345744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 PEARSON",
            "city": "BENTON",
            "state": "AR",
            "postal_code": "720154436",
            "telephone_number": "501-315-4224",
            "fax_number": "501-778-0450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 PEARSON",
            "city": "BENTON",
            "state": "AR",
            "postal_code": "720154436",
            "telephone_number": "501-315-4224",
            "fax_number": "501-778-0450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "STELLA",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-12-06",
        "last_updated": "2022-12-06",
        "certification_date": "2022-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "AR",
            "license": "L032957",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STELLA",
            "last_name": "HOOD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Dorothy Waldroup, QBHP
• Walgreen Co
• Walker Eye Care

• Licensed Practical Nurse in Benton, AR
• Providers in Benton, AR by specialty
• Licensed Practical Nurse in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2022; 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.