Teresa Ann Wagner, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

R100625 Issued in AR

Practice address

1036 Highway 64 E
Alma, AR 72921-6807

Phone

(479) 632-3813

Fax

(479) 632-8986

NPI assigned

Jul 24, 2024

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

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.

• Cedar Ridge, Inc

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Alma, AR
  • NPI 1184848202
  NPD (past)
• Stepping Stone School for Exceptional Children,Inc

  • Developmentally Disabled Services Day Training Agency
  • Alma, AR
  • NPI 1942356993
  NPD (past)

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

{
    "created_epoch": "1721779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721779200000",
    "number": "1508694274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2389",
            "city": "ALMA",
            "state": "AR",
            "postal_code": "729212389",
            "telephone_number": "479-632-3813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1036 HIGHWAY 64 E",
            "city": "ALMA",
            "state": "AR",
            "postal_code": "729216807",
            "telephone_number": "479-632-3813",
            "fax_number": "479-632-8986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "TERESA",
        "middle_name": "ANN",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-24",
        "last_updated": "2024-07-24",
        "certification_date": "2024-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AR",
            "license": "R100625",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dawson Urrutia
• Van Buren Hma, LLC
• Beverly Ann Vanover, LPC
• Jonelle Jean Villalobos
• Pamela Joyce Wadsworth, CCC-SLP
• Walgreen Co
• Walmart Inc.
• Jessica Hunter Walters
• Tonya Walters, RN
• Sara Elizabeth Watkins, OTR/L

• Registered Nurse in Alma, AR
• Providers in Alma, AR by specialty
• Registered Nurse in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2024; 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.