Lauren Suzanne Wagner

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

95237336 Issued in CA

Practice address

2200 Tydd St
Eureka, CA 95501-1284

Phone

(707) 441-1624

NPI assigned

Dec 31, 2020

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

State licenses

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

{
    "created_epoch": "1609372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609372800000",
    "number": "1518555960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "670 9TH ST STE 203",
            "city": "ARCATA",
            "state": "CA",
            "postal_code": "955216249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 TYDD ST",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955011284",
            "telephone_number": "707-441-1624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "LAUREN",
        "middle_name": "SUZANNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-31",
        "last_updated": "2020-12-31",
        "certification_date": "2020-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95237336",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Danielle Vonoch
• Jennifer Vu, RBT
• Jessica Rae Vulich, RN
• Anne C Wadham, PA-C
• Heather Wadhams
• Nichole Wagner
• Theresa Ann Wagner
• Zachary Wagner, MSN, APRN, NP-C
• Wahidullah Medical Corporation
• Wahidullah Wahidullah, M.D.

• Registered Nurse in Eureka, CA
• Providers in Eureka, CA by specialty
• Registered Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2020; 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.