Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Ebony Wagner

Individual provider Licensed Practical Nurse · NPI 1417402397

Ebony Wagner is a Licensed Practical Nurse in Florissant, Missouri. Licensed in Missouri. Registered with an NPI since 2016.

Licensed in
MO
In the registry since
2016

Practice location Address checks out

2325 Patterson Rd
Florissant, MO 63031-2205
Phone: (314) 620-5553
Fax: (314) 584-5002
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Licensed Practical Nurse (primary) Taxonomy 164W00000X · Licence 2013023536 (MO)

Record details

NPI number1417402397
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedAugust 19, 2016
Last updated in NPPESAugust 19, 2016

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