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NPI Code Detail

MEDICARE: ANNA K WAGLE NCC, MS

MEDICARE: ANNA K WAGLE NCC, MS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program
2101Y00000XCounselor

General Provider Information

NPI Number : 1558193581
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANNA K WAGLE NCC, MS
Provider Business Mailing Address
First Line : 200 TECH CENTER DR
Second Line :
City : KNOXVILLE
State : TN
Zip : 37912-2747
Country : US
Telephone Number : 865-637-9711
Fax Number :
Provider Business Practice Location Address
First Line : 201 W SPRINGDALE AVE
Second Line :
City : KNOXVILLE
State : TN
Zip : 37917-5158
Country : US
Telephone Number : 865-770-3002
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/19/2024
Last Update Date : 04/09/2026

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