Individual
LINDA WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
451 STERLING HWY, HOMER, AK 99603-7440
(907) 235-0369
Mailing address
4300 BARTLETT ST, HOMER, AK 99603-7005
(907) 235-0369
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
HH2711
AK
163WH0200X
Home Health Registered Nurse
HH2711
AK
171M00000X
Case Manager/Care Coordinator
CMG799
AK
171WH0202X
Home Modifications Contractor
Primary
HC2563
AK
372500000X
Chore Provider
HC2563
AK
3747P1801X
Personal Care Attendant
PCG519A
AK
374U00000X
Home Health Aide
HH2711
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
CMG799
—
AK
05
—
HC2563
—
AK
05
—
HH2711
—
AK
05
—
MSO272
—
AK
05
—
NA3799
—
AK
05
—
PCG519A
—
AK
Enumeration date
03/08/2007
Last updated
09/11/2025
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