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1306083480
BRIAN GEORGE WAGONER
SPRINGFIELD, MO
NPI
1306083480
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: MO 155580)
Enumeration Date
2009-01-12
Last Update Date
2009-06-10
Business Address
Mr. BRIAN GEORGE WAGONER RN, FNP BC
1235 E CHEROKEE ST
SPRINGFIELD, MO 65804-2203
Phone number: 417-820-9729
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Mailing Address
Mr. BRIAN GEORGE WAGONER RN, FNP BC
PO BOX 2580
SPRINGFIELD, MO 65801-2580
Phone number: 417-829-4620
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