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1609895317
STACIE WAGNER
PHOENIX, AZ
NPI
1609895317
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: AZ 2122)
Enumeration Date
2006-07-19
Last Update Date
2007-07-08
Business Address
-- STACIE WAGNER NNP
300 W CLARENDON AVE 375
PHOENIX, AZ 85013-3420
Phone number: 602-277-4161
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Mailing Address
-- STACIE WAGNER NNP
300 W CLARENDON AVE 375
PHOENIX, AZ 85013-3420
Phone number: 602-277-4161
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