Individual provider · Type 1 NPI

Laura Wagner

Medical Physician Assistant · Kingsport, TN

NPI number 1013628262 Active

Practice location

105 W Stone Dr Ste 1F
Kingsport, TN 37660-3365

Call (423) 230-2420 Map

Mailing address

PO Box 9
Kingsport, TN 37662-0009

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700XPA5304 (TN)

Medical Physician Assistant: Definition to come...

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About NPI 1013628262

Laura Wagner's National Provider Identifier is 1013628262, issued on Dec 8, 2022. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Kingsport, TN. The record was last updated on Jun 21, 2024.