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MARISSA JACQUELINE WAGNER EDMUNDS
NPI 1104657261
Student in an Organized Health Care Education/Training Program in Pocatello, ID

Active since August 12, 2024
921 S 8TH AVE STOP 8253, POCATELLO, ID 83209(208) 282-4726 Get Directions Write a Review

NPPES record last updated: August 12, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Marissa Jacqueline Wagner Edmunds NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MARISSA JACQUELINE WAGNER EDMUNDS (NPI 1104657261) is an individual student in an organized health care education/training program in Pocatello, Idaho and active in the NPI registry since August 2024.

NPPES Registry Identity

NPI1104657261
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameMARISSA JACQUELINE WAGNER EDMUNDS
Location Address921 S 8TH AVE STOP 8253Pocatello, ID 83209-0002
Mailing Address921 S 8th Ave Stop 8253Pocatello, ID 83209-0002 · (208) 282-4726
Phone(208) 282-4726
Sole ProprietorNo
Enumeration DateAugust 12, 2024
NPPES CertifiedAugust 11, 2024
✔ NPI 1104657261 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
921 S 8TH AVE STOP 8253, Pocatello, ID 83209
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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

HAO YAN
Student in an Organized Health Care Education/Training Program
921 S 8TH AVE STOP 8253
POCATELLO, ID 83209
Bannock County (208) 282-4726
MICHAEL BRIGGS
Student in an Organized Health Care Education/Training Program
921 S 8TH AVE STOP 8253
POCATELLO, ID 83209
Bannock County (208) 282-4726
KYLEE PEREZ
Student in an Organized Health Care Education/Training Program
921 S 8TH AVE STOP 8253
POCATELLO, ID 83209
Bannock County (208) 282-4726
MORGAN ELIZABETH MURRAY
Student in an Organized Health Care Education/Training Program
921 S 8TH AVE STOP 8253
POCATELLO, ID 83209
Bannock County (208) 282-4726
MADISON MONET RADASCH
Student in an Organized Health Care Education/Training Program
921 S 8TH AVE STOP 8253
POCATELLO, ID 83209
Bannock County (208) 282-4726
JASMINE ASHFORD
Student in an Organized Health Care Education/Training Program
921 S 8TH AVE STOP 8253
POCATELLO, ID 83209
Bannock County (208) 282-4726
JOSEPH SOREN ANDERSEN
Student in an Organized Health Care Education/Training Program
921 S 8TH AVE STOP 8253
POCATELLO, ID 83209
Bannock County (208) 282-4726
ANNA JEWEL LAUX
Student in an Organized Health Care Education/Training Program
921 S 8TH AVE STOP 8253
POCATELLO, ID 83209
Bannock County (208) 282-4726

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Marissa Wagner Edmunds's NPI number?

The NPI number for Marissa Wagner Edmunds is 1104657261. It was assigned to this individual provider in the NPPES registry on August 12, 2024.

Where is Marissa Wagner Edmunds located?

Marissa Wagner Edmunds practices at 921 S 8th Ave Stop 8253, Pocatello, ID 83209. The listed phone number is (208) 282-4726.

What is Marissa Wagner Edmunds's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

When was this NPI record last updated?

The NPPES record for Marissa Wagner Edmunds was last updated on August 12, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.