| NPI | 1154735173 |
|---|---|
| Former Name | CHRISTY A WAGNER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OH COA16610NP) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH 351663) |
| Enumeration Date | 2014-06-18 |
| Last Update Date | 2022-01-25 |