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

Tyler James Wagner

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1154024289

Tyler James Wagner is a Student in an Organized Health Care Education/Training Program in Portsmouth, Virginia. Registered with an NPI since 2023.

In the registry since
2023

Practice location Address checks out

620 John Paul Jones Cir
Portsmouth, VA 23708-2111
Phone: (757) 953-5000
Show map & directions

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

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X

Record details

NPI number1154024289
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedMarch 27, 2023
Last updated in NPPESMarch 27, 2023
Certification dateMarch 26, 2023
Mailing address15020 Deer Haven Pl, Newburg, MD 20664-6605

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