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1093156564
GWENYTH GRACE WAGNER
OLATHE, KS
NPI
1093156564
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LA2200X Nurse Practitioner, Adult Health
(Licence: KS 53-74969)
Enumeration Date
2013-07-12
Last Update Date
2021-03-23
Business Address
Mrs. GWENYTH GRACE WAGNER
407 S CLAIRBORNE RD
OLATHE, KS 66062-1857
Phone number: 913-393-9921
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Mailing Address
Mrs. GWENYTH GRACE WAGNER
405 S CLAIRBORNE RD STE 2
OLATHE, KS 66062-1774
Phone number: 913-730-3661
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