Holly Wagner, RN, FNPC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1029928 Issued in TX

Practice address

1400 N Texana St
Hallettsville, TX 77964-2099

Phone

(361) 798-3671

NPI assigned

Feb 12, 2021

Last updated

Feb 12, 2021By the provider in NPPES

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 TX

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, Registered Nurse

Practice roles

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

• Citizens Medical Center County of Victoria

  • General Acute Care Hospital
  • Victoria, TX
  • NPI 1124052162
  NPD (past)
• Lavaca Hospital District

  dba Lavaca Family Health Clinic

  • Rural Health Clinic/Center
  • Hallettsville, TX
  • NPI 1871555409
  NPD (past)

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

{
    "created_epoch": "1613088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613088000000",
    "number": "1326631128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1406 N TEXANA ST",
            "city": "HALLETTSVILLE",
            "state": "TX",
            "postal_code": "779642021",
            "telephone_number": "361-798-3671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 N TEXANA ST",
            "city": "HALLETTSVILLE",
            "state": "TX",
            "postal_code": "779642099",
            "telephone_number": "361-798-3671"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1406 N Texana St",
            "address_purpose": "LOCATION",
            "city": "Hallettsville",
            "state": "TX",
            "postal_code": "779642021",
            "country_code": "US",
            "telephone_number": "361-798-3671 x1520",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "HOLLY",
        "credential": "RN, FNPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-12",
        "last_updated": "2021-02-12",
        "certification_date": "2021-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1029928",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joshua Eric Torres, PT, DPT, ATC
• Victoria Vision Center LLC
• Shea Nicole Vogel
• Lamont Vuong
• Vysehrad Isd
• Wal-Mart Stores Texas LLC (Walmart Pharmacy 10-1067)
• Hannah F Weber
• Maurice Gilliam Wilkinson, M.D.
• Chelsea Laton Wimberly, PHARMD
• Clayton Wimberly, M.S. CCC-SLP

• Family Nurse Practitioner in Hallettsville, TX
• Providers in Hallettsville, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2021; 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.