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1417683277
SOPHIA COLLETTE WAGNER
METAIRIE, LA
NPI
1417683277
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner Family
(Licence: LA 226793)
Enumeration Date
2022-07-25
Last Update Date
2022-09-15
Business Address
SOPHIA COLLETTE WAGNER
4320 HOUMA BLVD FL 5
METAIRIE, LA 70006-2961
Phone number: 504-503-6565
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Mailing Address
SOPHIA COLLETTE WAGNER
4200 HOUMA BLVD
METAIRIE, LA 70006-2970
Phone number: 504-503-6781
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