| NPI | 1043811391 |
|---|---|
| Former Name | KARI BETH WAGNER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WI 10474) |
| Additional Taxonomies | 2084B0040X Psychiatry & Neurology, Behavioral Neurology & Neuropsychiatry (Licence: WI 10474-33) |
| 363L00000X Nurse Practitioner (Licence: WI 10474) | |
| Enumeration Date | 2020-11-03 |
| Last Update Date | 2024-01-29 |