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1609157569
PHYLLIS A. WAGNER
DAVIE, FL
NPI
1609157569
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: FL ARNP 670502)
Enumeration Date
2011-09-06
Last Update Date
2011-09-06
Business Address
-- PHYLLIS A. WAGNER ARNP
3390 SW 131ST TER
DAVIE, FL 33330-4618
Phone number: 954-424-0346
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Mailing Address
-- PHYLLIS A. WAGNER ARNP
3390 SW 131ST TER
DAVIE, FL 33330-4618
Phone number: 954-424-0346
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