Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Kimberly Dawn Wagner, FNP-BC

Individual provider Family Nurse Practitioner · NPI 1861266017

Kimberly Dawn Wagner, FNP-BC is a Nurse Practitioner in Crossville, Tennessee. Qualified in 2023, 3 years ago. Practices with Covenant Medical Group Inc, a 356-clinician group and accepts Medicare assignment. Licensed in Tennessee.

Years since qualifying
3
Licensed in
TN
In the registry since
2023
What do these letters mean?
FNP-BC — Family Nurse Practitioner, Board Certified
A family nurse practitioner certified by the ANCC.

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Practice location Address checks out

100 Lantana Rd Ste 202
Crossville, TN 38555-1903
Phone: (931) 484-5141
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 34905 (TN)

Record details

NPI number1861266017
Entity typeIndividual (Type 1)
GenderFemale
Credentials FNP-BC
Sole proprietorYes
NPI enumeratedNovember 8, 2023
Last updated in NPPESJanuary 8, 2025
Certification dateJanuary 8, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Covenant Medical Group Inc — 356 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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