KEISHA LYNN WAGNER

BROOKLYN, NY
NPI1639641889
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy363LF0000X Nurse Practitioner, Family
(Licence: NY  F343619-1)
Enumeration Date2018-12-28
Last Update Date2018-12-28
Business Address
KEISHA LYNN WAGNER
273 PUTNAM AVE
BROOKLYN, NY 11216-1613
Phone number: 917-682-4643
Mailing Address
KEISHA LYNN WAGNER
273 PUTNAM AVE
BROOKLYN, NY 11216-1613
Phone number: 917-682-4643