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1114202421
LORI J WAGNER
PHOENIX, AZ
NPI
1114202421
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Former Name
LORI M WAGNER
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LP0200X Nurse Practitioner, Pediatrics
(Licence: AZ AP4240)
Enumeration Date
2011-10-18
Last Update Date
2018-03-30
Business Address
LORI J WAGNER FNP
1919 E THOMAS RD
PHOENIX, AZ 85016-7710
Phone number: 602-933-0920
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Mailing Address
LORI J WAGNER FNP
3200 E CAMELBACK RD STE 250
PHOENIX, AZ 85018-2327
Phone number: 602-933-1814
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