Individual
MR. SCOTT BRIAN WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
795 MIDDLE ST, FALL RIVER, MA 02721-1798
(508) 674-5600
Mailing address
649 ALDEN ST APT 102, FALL RIVER, MA 02723-1827
(361) 549-2530
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
655472
TX
367500000X
Certified Registered Nurse Anesthetist
Primary
RN199950
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0034548-02
—
TX
Enumeration date
10/13/2005
Last updated
06/10/2026
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