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EBONY WAGNER
NPI 1417402397
Licensed Practical Nurse in Florissant, MO

Active since August 19, 2016
2325 PATTERSON RD, FLORISSANT, MO 63031(314) 620-5553(314) 584-5002 Get Directions Write a Review

NPPES record last updated: August 19, 2016. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Ebony Wagner NPPES

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

EBONY WAGNER (NPI 1417402397) is an individual licensed practical nurse in Florissant, Missouri, licensed in Missouri (2013023536) and active in the NPI registry since August 2016.

NPPES Registry Identity

NPI1417402397
Entity TypeIndividualFemale
Primary Taxonomy164W00000X
Provider Legal NameEBONY WAGNER
Location Address2325 PATTERSON RDFlorissant, MO 63031-2205
Mailing Address2325 Patterson RdFlorissant, MO 63031-2205 · (314) 620-5553 · Fax (314) 584-5002
Phone(314) 620-5553
Fax(314) 584-5002
Sole ProprietorNo
Enumeration DateAugust 19, 2016
✔ NPI 1417402397 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 MO · 2013023536
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.
2325 PATTERSON RD, Florissant, MO 63031
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Other Providers at the Same Location NPPES

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

CARING MOMENTS HOME HEALTH LLC
Health Maintenance Organization
2325 PATTERSON RD
FLORISSANT, MO 63031
St. Louis County (314) 620-5553

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 Ebony Wagner's NPI number?

The NPI number for Ebony Wagner is 1417402397. It was assigned to this individual provider in the NPPES registry on August 19, 2016.

Where is Ebony Wagner located?

Ebony Wagner practices at 2325 Patterson Rd, Florissant, MO 63031. The listed phone number is (314) 620-5553.

What is Ebony 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 Ebony Wagner was last updated on August 19, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years 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.