Dr. William Robert Wagner
Clinical Social Worker Nurse Practitioner - Gerontology Nurse Practitioner - Adult Health
1000 Health Center Road Kyle Health Center / Dhhs/ihs
Kyle
, South Dakota 57752
Dr. William Robert Wagner
Clinical Social Worker Nurse Practitioner - Gerontology Nurse Practitioner - Adult Health
1000 Health Center Road Kyle Health Center / Dhhs/ihs
Kyle
, South Dakota 57752
(917) 626-9011
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About
Features
Specialties
- Clinical Social Worker
- Nurse Practitioner - Adult Health
- Nurse Practitioner - Gerontology
Languages spoken
- English
Location
First Address
- Dr. William Robert Wagner
- 1000 Health Center Road Kyle Health Center / Dhhs/ihs
- Kyle, SD
- Zip : 57752
- Phone : (917) 626-9011
Second Address
- Dr. William Robert Wagner
- 1000 Health Center Road Kyle Health Center / Dhhs/ihs
- Kyle, SD
- Zip : 57752
- Phone : (917) 626-9011
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 1041C0700X | Clinical Social Worker | R055430 | NY |
| Y | 363LA2200X | Nurse Practitioner - Adult Health | F304782 | NY |
| N | 363LG0600X | Nurse Practitioner - Gerontology | F340615 | NY |
National Provider Identifier
| NPI | 1043219587 |
|---|---|
| Provider Name | Dr. William Robert Wagner |
| First Address | Kyle, SD 57752 |
| Second Address | Kyle, SD 57752 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 18/07/2005 |
| Last Update Date | 29/04/2016 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| Q59896 | (02) |
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.