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

Laura Wagner

Individual provider Medical Physician Assistant · NPI 1013628262

Laura Wagner is a Physician Assistant in Kingsport, Tennessee. Graduated from Lincoln Memorial University Medical Department in 2022, 4 years ago. Practices with Holston Medical Group PC, a 242-clinician group and accepts Medicare assignment. Licensed in Tennessee.

Years since qualifying
4
Trained at
Lincoln Memorial University Medical Department
Licensed in
TN
In the registry since
2022

Practice location Address checks out

105 W Stone Dr Ste 1F
Kingsport, TN 37660-3365
Phone: (423) 230-2420
Show map & directions

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

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence PA5304 (TN)

Record details

NPI number1013628262
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedDecember 8, 2022
Last updated in NPPESJune 21, 2024
Certification dateJune 21, 2024
Mailing addressPo Box 9, Kingsport, TN 37662-0009

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolLINCOLN MEMORIAL UNIVERSITY MEDICAL DEPARTMENT
Graduated 2022 (4 years in practice)
Group practice Holston Medical Group Pc — 242 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in Kingsport