Kathleen Mary Wagner
ARNP | Nurse Practitioner
1223 Gateway Drive, Melbourne
Florida, 32901-2607
321-725-4500
Kathleen Mary Wagner is a Melbourne, Florida based nurse practitioner. Active license number of Kathleen Mary Wagner is ARNP9333175 for Obstetrics & Gynecology in Florida. Her current practice location is 1223 Gateway Drive, Melbourne. Patients can reach her at 321-725-4500 or can fax her at 321-722-1237. Kathleen Mary Wagner is ARNP and her NPI number (Unique professional ID assigned by NPPES) is 1740397041.
Kathleen Mary Wagner has completed additional training beyond basic nursing education and provides primary health care services in accordance with state nurse practice laws or statutes. NPs are trained to assess patient needs, order and interpret diagnostic and laboratory tests, diagnose disease, formulate and prescribe medications and treatment plans.
Complete Profile:
Kathleen Mary Wagner speciality, credentials, practice address, contact phone number and fax are as below.
Patients can call on the below given phone number for appointment.
| Name: | Kathleen Mary Wagner |
| Specialization: | Nurse Practitioner (NP) |
| Gender: | Female |
| Credentials: | ARNP |
| Practice Address: | 1223 Gateway Drive, Melbourne,
Florida, 32901-2607 |
| Phone: | 321-725-4500 |
| Fax: | 321-722-1237 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details are as mentioned below.
| NPI Number: | 1740397041 |
| NPI Enumeration Date: | 23 Aug, 2006 |
| NPI Last Update On: | 07 Sep, 2012 |
Medical Licenses:
NPs can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Kathleen Mary Wagner are as mentioned below.
| License Number | Specialization | State | Status | |
| ARNP9333175 | Obstetrics & Gynecology | Florida | Primary | |
| AP30000510 | Nurse Practitioner | Washington | Secondary | |
Other Medical Identifiers:
Other legacy medical identifiers associated with Kathleen Mary Wagner such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| 9649823 | Medicaid | Washington | |
| 0212946 | Other | Washington | LABOR & INDUSTRIES |
| 807564400 | Medicaid | Idaho | |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | Kathleen Mary Wagner
1223 Gateway Drive,
Melbourne, Florida |
| Zip: | 32901-2607 |
| Phone Number: | 321-725-4500 |
| Fax Number: | 321-722-1237 |
Patients can reach Kathleen Mary Wagner at
1223 Gateway Drive, Melbourne, Florida or can
call to book an appointment on 321-725-4500.
Comments/ Reviews:
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Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 December, 2025.