Dr. Kimberly N Wagner
Physical Therapist - Pediatrics
750 Coronado Center Dr Suite 120
Henderson
, Nevada 89052-5034
Dr. Kimberly N Wagner
Physical Therapist - Pediatrics
750 Coronado Center Dr Suite 120
Henderson
, Nevada 89052-5034
(903) 453-1709
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About
Features
Specialties
- Physical Therapist - Pediatrics
Languages spoken
- English
Location
First Address
- Dr. Kimberly N Wagner
- 6617 Sunset Pines St
- Las Vegas, NV
- Zip : 89148-4251
- Phone : (903) 453-1709
Second Address
- Dr. Kimberly N Wagner
- 750 Coronado Center Dr Suite 120
- Henderson, NV
- Zip : 89052-5034
- Phone : (702) 564-4116
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 2251P0200X | Physical Therapist - Pediatrics | 2757 | NV |
National Provider Identifier
| NPI | 1104176593 |
|---|---|
| Provider Name | Dr. Kimberly N Wagner |
| First Address | Las Vegas, NV 89148-4251 |
| Second Address | Henderson, NV 89052-5034 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 13/09/2012 |
| Last Update Date | 30/09/2019 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.