Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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MS. Randi Lynn Wagner, PA-C

Individual provider Physician Assistant · NPI 1417411349

MS. Randi Lynn Wagner, PA-C is a Physician Assistant in Chattanooga, Tennessee. Practices as a sole proprietor. Licensed in California and Tennessee.

Licensed in
CA, TN
In the registry since
2019
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

10 Glenron St
Chattanooga, TN 37415-2112
Phone: (651) 261-3878
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 4258 (TN)
Physician Assistant Taxonomy 363A00000X · Licence PA60130 (CA)

Record details

NPI number1417411349
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorYes
NPI enumeratedJanuary 24, 2019
Last updated in NPPESSeptember 4, 2024
Certification dateSeptember 4, 2024

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