Individual provider Active NPI

Diane Elizabeth Wagner, LPN

  • Licensed Practical Nurse
  • Anchorage, AK
National Provider Identifier
1801705074
Registry record updated Sep 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
253900 Issued in AK
Practice address
4000 Old Seward Hwy Ste 300
Anchorage, AK 99503-6079
Phone
(907) 770-0862
NPI assigned
Sep 3, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 3, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 253900 AK Primary

Addresses

Primary practice location

4000 Old Seward Hwy Ste 300
Anchorage, AK 99503-6079

Mailing address

4000 Old Seward Hwy Ste 300
Anchorage, AK 99503-6079
Phone (907) 770-0862

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1788393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788393600000",
    "number": "1801705074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 OLD SEWARD HWY STE 300",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995036079",
            "telephone_number": "907-770-0862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 OLD SEWARD HWY STE 300",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995036079",
            "telephone_number": "907-770-0862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "DIANE",
        "middle_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-09-03",
        "last_updated": "2026-09-03",
        "certification_date": "2026-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "AK",
            "license": "253900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.