STACIE WAGNER

PHOENIX, AZ
NPI1609895317
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: AZ  2122)
Enumeration Date2006-07-19
Last Update Date2007-07-08
Business Address
-- STACIE WAGNER NNP
300 W CLARENDON AVE 375
PHOENIX, AZ 85013-3420
Phone number: 602-277-4161
Mailing Address
-- STACIE WAGNER NNP
300 W CLARENDON AVE 375
PHOENIX, AZ 85013-3420
Phone number: 602-277-4161