LEE SHANNON WAGNER

PENSACOLA, FL
NPI1316442361
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy207Q00000X Family Medicine
(Licence: AL  42864)
Additional Taxonomies207Q00000X Family Medicine
(Licence: FL  ME176128)
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2018-03-29
Last Update Date2025-09-09
Business Address
LEE SHANNON WAGNER M.D.
5100 N 12TH AVE STE 201
PENSACOLA, FL 32504-8919
Phone number: 448-227-6330
Mailing Address
LEE SHANNON WAGNER M.D.
PO BOX 95590
SOUTH JORDAN, UT 84095-0590
Phone number: 801-352-9500