Teresa Moore Wagner, RN, CDE is a 
Licensed Practical Nurse based in Buckeye, West Virginia. Teresa Moore Wagner is licensed to practice in West Virginia (license number 30547) and her current practice location is 
150 Duncan Road, Buckeye, West Virginia. She can be reached at her office (for appointments etc.) via phone at 
(304) 799-7400.
NPI number for Teresa Moore Wagner is 1063572717 and her current mailing address is 150 Duncan Road, Buckeye, West Virginia. She 
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1063572717.
				
				
				
				
				
		 
		
		 
Provider's Profile
		
			
			
			| Full Name | Teresa Moore Wagner | 
|---|
| Gender | Female | 
|---|
| Speciality | Licensed Practical Nurse | 
|---|
| Location | 150 Duncan Road, Buckeye, West Virginia | 
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. | 
			
			 
			
						  NPI Data:
			
			- NPI Number: 1063572717
 - Provider Enumeration Date: 12/11/2006
 - Last Update Date: 09/23/2015
 			
			
			 
		 
		 
Medical Identifiers
		Medical identifiers for Teresa Moore Wagner such as npi, medicare ID, medicare PIN, medicaid, etc.
		
		| Identifier | Type | State | Issuer | 
		| 1063572717 | NPI | - | NPPES | 
		
		 
Medical Taxonomies and Licenses
		
		| Taxonomy | Type | License (State) | Status | 
		| 163WD0400X | Registered Nurse - Diabetes Educator  | 30547 (West Virginia) | Secondary | 
| 164W00000X | Licensed Practical Nurse  | 30547 (West Virginia) | Primary | 
		
		
			
			
			
		
		
		 
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Teresa Moore Wagner is 
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
		
		
 
Mailing Address and Practice Location
		
		| Mailing Address | Practice Location Address | 
		Teresa Moore Wagner, RN, CDE 150 Duncan Road, Buckeye, WV 24924-9037 Ph: (304) 799-7400 | Teresa Moore Wagner, RN, CDE 150 Duncan Road, Buckeye, WV 24924-9037 Ph: (304) 799-7400 | 
		
		 
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