Judy Lynn Wagner, NP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

A0805296 Issued in MN

Practice address

1 Veterans Dr
Minneapolis, MN 55417-2309

Phone

(612) 725-2000

NPI assigned

Aug 13, 2006

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

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1155427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343347200000",
    "number": "1295747491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 VETERANS DR",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554172309",
            "telephone_number": "612-725-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 VETERANS DR",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554172309",
            "telephone_number": "612-725-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "JUDY",
        "middle_name": "LYNN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-13",
        "last_updated": "2012-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MN",
            "license": "A0805296",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Catherine Wagner, RN
• Erin Connelly Wagner
• Gerardette Annamarie Wagner, RN
• Jacob Wagner, M.D.
• John E Wagner, MD
• Kirsten Wagner
• Kristina Wagner
• Megan Wagner
• Mitchell John Wagner, DC
• Pamela E. Wagner, CRNA

• Adult Health Nurse Practitioner in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Adult Health Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.