CAROLYN WAGNER

DECATUR, IL
NPI1366419087
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LF0000X Nurse Practitioner, Family
(Licence: IL  209-001389)
Enumeration Date2006-03-01
Last Update Date2011-03-10
Business Address
Mrs. CAROLYN WAGNER NP
1770 E LAKE SHORE DR SUITE 207
DECATUR, IL 62521-3832
Phone number: 217-429-9700
Mailing Address
Mrs. CAROLYN WAGNER NP
1770 E LAKE SHORE DR SUITE 207
DECATUR, IL 62521-3832
Phone number: 217-429-9700
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