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

Sophia Collette Wagner

Individual provider Family Nurse Practitioner · NPI 1417683277

Sophia Collette Wagner is a Nurse Practitioner in Metairie, Louisiana. Qualified in 2022, 4 years ago. Practices with East Jefferson Physicians Group LLC, a 211-clinician group and accepts Medicare assignment. Licensed in Louisiana.

Years since qualifying
4
Licensed in
LA
In the registry since
2022
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Practice location Address checks out

4320 Houma Blvd Fl 5
Metairie, LA 70006-2961
Phone: (504) 503-6565
Fax: (504) 456-8053
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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 226793 (LA)

Record details

NPI number1417683277
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJuly 25, 2022
Last updated in NPPESSeptember 15, 2022
Certification dateSeptember 13, 2022

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice East Jefferson Physicians Group Llc — 211 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Metairie