Provider Demographics
NPI:1699027995
Name:WAFER, ANNIE M (NP)
Entity Type:Individual
Prefix:
First Name:ANNIE
Middle Name:M
Last Name:WAFER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 BUSINESS PARK DR
Mailing Address - Street 2:
Mailing Address - City:UTICA
Mailing Address - State:NY
Mailing Address - Zip Code:13502-6303
Mailing Address - Country:US
Mailing Address - Phone:315-798-1516
Mailing Address - Fax:315-798-1528
Practice Address - Street 1:117 BUSINESS PARK DR
Practice Address - Street 2:
Practice Address - City:UTICA
Practice Address - State:NY
Practice Address - Zip Code:13502-6303
Practice Address - Country:US
Practice Address - Phone:315-798-1516
Practice Address - Fax:315-798-1528
Is Sole Proprietor?:No
Enumeration Date:2012-10-10
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY337621363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily