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Judith R Wagner

Female

Medical Specialty

Certified Registered Nurse Anesthetist

Professional ID

NPI: 1548285067
PECOS ID: 9234193426
Enrollment ID: I20041117000576
Credential(MD, DO, DPM): CNA
Medical School:
Medical School Graduation Year: 1973

Hospital Service

Hospital CCN1: 340113
Business Name (LBN)1: Carolinas Medical Centerbehav Health

Medical Practices

Organization Name: Carolinas Medical Center
Group Practice ID assigned by PECOS: 4789597477
Number of Group Practice member: 920

Location

Address1: 1000 Blythe Blvd
Address2:
City: Charlotte
State: North Carolina
Zip Code: 28203
Phone Number: (704)355-2000

Medicare

Medicare Assignment: Yes
Report Quality of Care to Physician Quality Reporting System (PQRS): Yes
Used Electronic health record (EHR):