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1033882907
MARISSA WAGNER
ORANGE CITY, FL
NPI
1033882907
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: FL 11013967)
Enumeration Date
2021-07-27
Last Update Date
2021-07-27
Business Address
MARISSA WAGNER APRN
2884 WELLNESS AVE STE 100
ORANGE CITY, FL 32763-8427
Phone number: 386-668-2221
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Mailing Address
MARISSA WAGNER APRN
1071 CALLA LILY CV
OVIEDO, FL 32766-0003
Phone number: 407-257-1363
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