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MRS. KIMBERLY ANN WAGNER
NPI 1114237575
Licensed Practical Nurse in Lebanon, IL

Active since October 19, 2010
1 PERRYMAN ST, LEBANON, IL 62254(618) 537-6165 Get Directions Write a Review

NPPES record last updated: October 19, 2010. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Mrs. Kimberly Ann Wagner NPPES

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

MRS. KIMBERLY ANN WAGNER (NPI 1114237575) is an individual licensed practical nurse in Lebanon, Illinois, licensed in Illinois (043.085404) and active in the NPI registry since October 2010.

NPPES Registry Identity

NPI1114237575
Entity TypeIndividualFemale
Primary Taxonomy164W00000X
Provider Legal NameMRS. KIMBERLY ANN WAGNER
Location Address1 PERRYMAN STLebanon, IL 62254-1356
Mailing Address1 Perryman StLebanon, IL 62254-1356
Phone(618) 537-6165
Sole ProprietorNo
Enumeration DateOctober 19, 2010
✔ NPI 1114237575 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyLicensed Practical NurseNursing Service Providers
Taxonomy Code164W00000X
License✔ Licensed in IL · 043.085404
Definition
A licensed practical nurse with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.
1 PERRYMAN ST, Lebanon, IL 62254
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Other Providers at the Same Location NPPES 9

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

CEP AMERICA - ILLINOIS SNF, LLP
Internal Medicine
1 PERRYMAN ST
LEBANON, IL 62254
St. Clair County (618) 537-6165
ASHLEI L MOSES
Physical Therapy Assistant
1 PERRYMAN ST
LEBANON, IL 62254
St. Clair County (618) 537-6165
CEDAR RIDGE CARE AND REHABILITATION CENTER LLC
Durable Medical Equipment & Medical Supplies (Oxygen Equipment & Supplies)
1 PERRYMAN ST
LEBANON, IL 62254
St. Clair County (618) 537-6165
CEDAR RIDGE CARE AND REHABILITATION CENTER LLC
Skilled Nursing Facility
1 PERRYMAN ST
LEBANON, IL 62254
St. Clair County (618) 537-6165
COVENANT CARE MIDWEST, INC.
Skilled Nursing Facility
1 PERRYMAN ST
LEBANON, IL 62254
St. Clair County (618) 537-6165
ANDREA BAHAN MPT
Physical Therapist
1 PERRYMAN ST
LEBANON, IL 62254
St. Clair County (618) 537-6165
CEDAR RIDGE CARE AND REHABILITATION CENTER LLC
Non-emergency Medical Transport (VAN)
1 PERRYMAN ST
LEBANON, IL 62254
St. Clair County (618) 537-6165
ADRIENNE KLEIN PT
Physical Therapist
1 PERRYMAN ST
LEBANON, IL 62254
St. Clair County (618) 537-6165

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 Kimberly Wagner's NPI number?

The NPI number for Kimberly Wagner is 1114237575. It was assigned to this individual provider in the NPPES registry on October 19, 2010.

Where is Kimberly Wagner located?

Kimberly Wagner practices at 1 Perryman St, Lebanon, IL 62254. The listed phone number is (618) 537-6165.

What is Kimberly Wagner's specialty?

The primary specialty registered for this NPI is Licensed Practical Nurse with taxonomy code 164W00000X.

When was this NPI record last updated?

The NPPES record for Kimberly Wagner was last updated on October 19, 2010. NPI Profile syncs with the weekly NPPES data releases published by CMS.