Individual
RACHEL WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
1400 GRAND AVE, NEWPORT, KY 41071-2570
(859) 572-3366
(859) 572-3568
Mailing address
PO BOX 635283, CINCINNATI, OH 45263-5283
(859) 212-4625
(859) 212-4638
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
169038
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
K224130
MEDICARE
KY
Enumeration date
04/10/2017
Last updated
01/08/2026
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