Active NPI
Roberta Lynn Huna Wagner, AG-CNS
- Gerontology Clinical Nurse Specialist
- Minneapolis, MN
National Provider Identifier
1932661402
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gerontology Clinical Nurse Specialist
- License
- 539
- Practice address
- 800 E 28TH St # Mr 94100
Minneapolis, MN 55407-3799 - Phone
- (612) 775-3582
- NPI assigned
- Apr 3, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gerontology Clinical Nurse Specialist | 364SG0600X | 539 | MN | Primary |
Addresses
Primary practice location
800 E 28TH St # Mr 94100
Minneapolis, MN 55407-3799
Mailing address
800 E 28TH St # Mr 94100
Minneapolis, MN 55407-3799
Phone (612) 775-3582
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 539 | MN | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1554249600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1554249600000",
"number": "1932661402",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "800 E 28TH ST # MR 94100",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554073799",
"telephone_number": "612-775-3582"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 E 28TH ST # MR 94100",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554073799",
"telephone_number": "612-775-3582"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAGNER",
"first_name": "ROBERTA",
"middle_name": "LYNN HUNA",
"credential": "AG-CNS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-04-03",
"last_updated": "2019-04-03",
"status": "A"
},
"taxonomies": [
{
"code": "364SG0600X",
"taxonomy_group": "",
"desc": "Clinical Nurse Specialist, Gerontology",
"state": "MN",
"license": "539",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.