Collette Munster Wagner, MSN, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

218321 Issued in LA

Practice address

1305 W Causeway Approach
Mandeville, LA 70471-3043

Phone

(985) 674-2227

NPI assigned

Jan 21, 2021

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Leblanc Pediatrics LLC

  • Pediatrics Physician
  • Mandeville, LA
  • NPI 1386928042
  NPD (past)
• Warren Health Care Alliance, PC

  • Internal Medicine Physician
  • Phillipsburg, NJ
  • NPI 1568408490
  NPD (past)

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

{
    "created_epoch": "1611187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611187200000",
    "number": "1316537673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 ORLEANS AVE",
            "city": "COVINGTON",
            "state": "LA",
            "postal_code": "704336245",
            "telephone_number": "504-909-6410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1305 W CAUSEWAY APPROACH",
            "city": "MANDEVILLE",
            "state": "LA",
            "postal_code": "704713043",
            "telephone_number": "985-674-2227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "COLLETTE",
        "middle_name": "MUNSTER",
        "credential": "MSN, NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-21",
        "last_updated": "2021-01-21",
        "certification_date": "2021-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "218321",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "EPIC",
            "affiliation": "N",
            "endpointDescription": "EHR",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1305 W Causeway Approach",
            "city": "Mandeville",
            "state": "LA",
            "country_code": "US",
            "postal_code": "704713043",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Theresa M Voorhies, MD
• Savannah Dai Vorenkamp
• Nga Vu
• W Hayes Hughes
• Wade'S Transportation
• Genevieve Francis Waguespack
• Anna Wahl, M.S., CCC-SLP
• Adele R Wainright, RPH
• Wal-Mart
• Wal-Mart Stores East LP

• Family Nurse Practitioner in Mandeville, LA
• Providers in Mandeville, LA by specialty
• Family Nurse Practitioner in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2021; 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.