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 |