Courtney Ann Wagner, PA-C
Physician Assistant in Chesterfield, MO. Individual provider (NPI-1).
NPI number1073818878
StatusActive
Last updated in NPPESSep 17, 2025
Details
- NPI
- 1073818878
- Entity type
- Individual (NPI-1)
- Name
- Ms. Courtney Ann Wagner
- Credential
- PA-C
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jan 26, 2011
- Certification date
- Sep 17, 2025
- Last updated
- Sep 17, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | 2018002158 | MO | Yes |
| 363AM0700X | Physician Assistant, Medical | 2018002158 | MO |
Practice location
16100 Chesterfield Pkwy W Ste 175Chesterfield, MO 63017
Phone 314-735-0780 · Fax 314-735-1625
Mailing address
16100 Chesterfield Pkwy W Ste 175Chesterfield, MO 63017
Phone 314-735-0780 · Fax 314-735-1625
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All 44 Physician Assistant providers in Chesterfield · All 2,881 providers in Chesterfield
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