Individual provider · Type 1 NPI

Marissa Jacqueline Wagner Edmunds, PA-C

Physician Assistant · Fort Collins, CO

NPI number 1104657261 Active

Practice location

702A W Drake Rd
Fort Collins, CO 80526-5521

Specialties and licenses

TaxonomyCodeLicense
Family Medicine Physician 207Q00000XPA.0010167 (CO)
Physician Assistant Primary 363A00000XPA.0010167 (CO)

Physician Assistant: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, orde…

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About NPI 1104657261

Marissa Jacqueline Wagner Edmunds, PA-C's National Provider Identifier is 1104657261, issued on Aug 12, 2024. The primary taxonomy on file is Physician Assistant (363A00000X), and the practice location is in Fort Collins, CO. The record was last updated on Oct 30, 2026.