KEISHA LYNN WAGNER
NPI 1639641889
Nurse Practitioner - Family in Brooklyn, NY

Q: What is Keisha Wagner's NPI number?

The NPI number for Keisha Wagner is 1639641889. It was assigned to this individual provider in the NPPES registry on December 28, 2018.

Q: What is Keisha Wagner's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Keisha Wagner was last updated on December 28, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.

Active since December 28, 2018

273 PUTNAM AVE, BROOKLYN, NY 11216(917) 682-4643 Get Directions Write a Review

NPPES record last updated: December 28, 2018. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Keisha Lynn Wagner NPPES

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

KEISHA LYNN WAGNER (NPI 1639641889) is an individual family provider in Brooklyn, New York, licensed in New York (F343619-1) and active in the NPI registry since December 2018.

NPPES Registry Identity

NPI1639641889

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameKEISHA LYNN WAGNER

Location Address273 PUTNAM AVEBrooklyn, NY 11216-1613

Mailing Address273 Putnam AveBrooklyn, NY 11216-1613 · (917) 682-4643

Phone(917) 682-4643

Sole ProprietorYes

Enumeration DateDecember 28, 2018

✔ NPI 1639641889 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in NY · F343619-1

273 PUTNAM AVE, Brooklyn, NY 11216

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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 Keisha Wagner's NPI number?

The NPI number for Keisha Wagner is 1639641889. It was assigned to this individual provider in the NPPES registry on December 28, 2018.

Where is Keisha Wagner located?

Keisha Wagner practices at 273 Putnam Ave, Brooklyn, NY 11216. The listed phone number is (917) 682-4643.

What is Keisha Wagner's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

When was this NPI record last updated?

The NPPES record for Keisha Wagner was last updated on December 28, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.