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1306035571
KELLY E VAN WAGNER
N. LAS VEGAS, NV
NPI
1306035571
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
207R00000X Internal Medicine
(Licence: NV 9533)
Enumeration Date
2007-10-23
Last Update Date
2023-02-13
Business Address
Dr. KELLY E VAN WAGNER M.D.
6380 N. DECATUR BLVD STE 215
N. LAS VEGAS, NV 89084
Phone number: 702-948-1145
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Mailing Address
Dr. KELLY E VAN WAGNER M.D.
6355 S BUFFALO DR FL 3
LAS VEGAS, NV 89113-2133
Phone number: 702-216-3346
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