Erin Leigh Wagner

Primary specialty

Licensed Vocational NurseTaxonomy code 164X00000X

License

343643 Issued in TX

Practice address

2058 Berger Rd
Victoria, TX 77905-5208

Phone

(361) 550-8856

NPI assigned

Dec 31, 2018

Sex

Female

Sole proprietor

No

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, last updated by the provider on Dec 31, 2018.

{
    "created_epoch": "1546214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546214400000",
    "number": "1578035697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1682 COUNTY ROAD 310",
            "city": "YOAKUM",
            "state": "TX",
            "postal_code": "779956079",
            "telephone_number": "361-648-1258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2058 BERGER RD",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779055208",
            "telephone_number": "361-550-8856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "ERIN",
        "middle_name": "LEIGH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-31",
        "last_updated": "2018-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "TX",
            "license": "343643",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• W.H. Shuttlesworth D.D.S., Inc.
• Christine Renee Wachsmuth, R.PH.
• Christine Mary Wagner, LCSW
• Derrick C Wagner, FNP-C
• Donna RM Wagner, M.D.
• Pamela Coy Wagner, RN, FNP
• William Jordan Wagner Jr., M.D.
• Loren C Wakham, O.D.
• Wal-Mart Stores Texas LLC
• Wal-Mart Stores Texas LLC

• All providers in Victoria, TX
• Licensed Vocational Nurse in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2018; 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.