Miss Lacey Elizabeth Ruth Wagner, RN is a
Registered Nurse - School based in Davenport, Nebraska. Miss Lacey Elizabeth Ruth Wagner is licensed to practice in Nebraska (license number 78245) and her current practice location is
106 N Juniper Ave, Davenport, Nebraska. She can be reached at her office (for appointments etc.) via phone at
(402) 364-2225.
NPI number for Miss Lacey Elizabeth Ruth Wagner is 1275367294 and her current mailing address is Po Box 273, Bruning, Nebraska. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1275367294.
Provider's Profile
Full Name | Miss Lacey Elizabeth Ruth Wagner |
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Gender | Female |
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Speciality | Registered Nurse - School |
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Location | 106 N Juniper Ave, Davenport, Nebraska |
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Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1275367294
- Provider Enumeration Date: 08/30/2024
- Last Update Date: 08/30/2024
Medical Identifiers
Medical identifiers for Miss Lacey Elizabeth Ruth Wagner such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1275367294 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
163WS0200X | Registered Nurse - School | 78245 (Nebraska) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Miss Lacey Elizabeth Ruth Wagner is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Miss Lacey Elizabeth Ruth Wagner, RN Po Box 273, Bruning, NE 68322-0273 Ph: (402) 759-2742 | Miss Lacey Elizabeth Ruth Wagner, RN 106 N Juniper Ave, Davenport, NE 68335-3010 Ph: (402) 364-2225 |
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