SAMANTHA ELIZABETH WAGNER

ROCKFORD, IL
NPI1538631114
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363L00000X Nurse Practitioner
(Licence: IL  209-018557)
Enumeration Date2018-12-20
Last Update Date2024-05-20
Business Address
SAMANTHA ELIZABETH WAGNER APRN
7180 SPRING BROOK RD
ROCKFORD, IL 61114-6700
Phone number: 779-696-2750
Mailing Address
SAMANTHA ELIZABETH WAGNER APRN
PO BOX 78866
MILWAUKEE, WI 53278-8866
Phone number: 779-696-7150
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