Doctor Name: | MATTHEW WAGNER |
NPI Number: | 1053785840 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | R 170201-9 |
Business Practice Address: | 210 9th St Se Rochester, MN - 559046756 |
Business Phone Number: | 5072883443 |
Business Fax Number: | |
Mailing Address: | 210 9th St Se, ROCHESTER |
State: | MN |
Postal Code: | 559046756 |
Phone Number: | 5072883443 |
Fax Number: | |
NPI Enumeration Date: | 11/17/2015 |
NPI Last Update Date: | 02/11/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 163W00000X |
License Number: | R 170201-9 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | MN |
Taxonomy Type: | Nursing Service Providers |
Taxonomy Classification: | Registered Nurse |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) A registered nurse is a person qualified by graduation from an accredited nursing school (depending upon schooling, a registered nurse may receive either a diploma from a hospital program, an associate degree in nursing (A.D.N.) or a Bachelor of Science degree in nursing (B.S.N.), who is licensed or certified by the state, and is practicing within the scope of that license or certification. R.N. |