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1134993322
SHAUNA R WAGNER
FORT WAYNE, IN
NPI
1134993322
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Former Name
SHAUNA R BROSOSKY
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
207Q00000X Family Medicine
(Licence: IN 28144054A)
Enumeration Date
2023-11-08
Last Update Date
2024-04-02
Business Address
SHAUNA R WAGNER NP
11055 TWIN CREEKS CV
FORT WAYNE, IN 46845-2204
Phone number: 260-425-6120
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Mailing Address
SHAUNA R WAGNER NP
11109 PARKVIEW PLAZA DR # 117
FORT WAYNE, IN 46845-1701
Phone number:
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