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MS. JONI WAGNER PA-C
>> Physician Assistant >> Physician Assistants & Advanced Practice Nursing ProvidersRegistrant NPI Number: 1992775027
Individual Registrant:MS. JONI WAGNER PA-C
Gender: F
Not Sole Proprietor
Gender: F
Not Sole Proprietor
Location and contact information for practice:
740 S HILL ST SALEM, SD 57058-8760 US
Tel: 605-425-2855 Fax: 605-425-2149
Tel: 605-425-2855 Fax: 605-425-2149
Contact information for business:
PO BOX 86430 SIOUX FALLS, SD 57118-6430 US
Tel: 605-322-4900 Fax: 605-322-4925
Tel: 605-322-4900 Fax: 605-322-4925
Registration Information:
NPI: 1992775027
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 363A00000X | Physician Assistants & Advanced Practice Nursing Providers Physician Assistant | SD | 0481 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| MIDLAND'S CHOICE | 234724 | SD | 01 |
| DAKOTACARE | 9238086 | SD | 01 |
| MEDICARE PTAN | S1639 | SD | 01 |
| MEDICA | 01-11971 | SD | 01 |
| PREFERRED ONE | AH1311029419 | SD | 01 |
| HEALTH PARTNERS | HP34870 | SD | 01 |
| WELLMARK | 4997236 | SD | 01 |
| AVERA HEALTH | 2843 | SD | 01 |
| 6823310 | SD | 05 |
