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

Individual provider Family Nurse Practitioner · NPI 1376775098

Mary Lanier Huntley-Wagner, FNP is a Nurse Practitioner in Virginia Beach, Virginia. Qualified in 2009, 17 years ago. Practices with Tidewater Physicians Multispecialty Group, PC, a 269-clinician group and accepts Medicare assignment. Licensed in Virginia.

Years since qualifying
17
Licensed in
VA
In the registry since
2009
What do these letters mean?
FNP — Family Nurse Practitioner
A nurse practitioner who treats patients of all ages, much like a family doctor.

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Practice location Address checks out

813 Independence Blvd
Virginia Beach, VA 23455-6004
Phone: (757) 333-7625
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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 0024168926 (VA)

Record details

NPI number1376775098
Entity typeIndividual (Type 1)
GenderFemale
Credentials FNP
Sole proprietorNo
NPI enumeratedAugust 13, 2009
Last updated in NPPESDecember 2, 2019

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2009 (17 years in practice)
Group practice Tidewater Physicians Multispecialty Group, Pc — 269 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

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