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Contact Information

TERESA M WAGNER, RN, CDE
150 DUNCAN ROAD
BUCKEYE, WV24924-9037
 Phone: 304-799-7400
 Fax: 304-799-2276
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Licensed Practical Nurse

164W00000X
 

Diabetes Educator

163WD0400X
Indicates primary specialty

NPI Profile & details for TERESA M WAGNER · (Female)

NPI Number 1063572717
Status Active
Credentials RN, CDE
Entity Individual
Enumeration date 12/11/2006
Last updated 09/23/2015 - About 11 years ago
Sole proprietor 1 No
Identifiers
  • WV License # 30547
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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