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1841295987
FAITH P WAGNER
LA CROSSE, WI
NPI
1841295987
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: WI 1778)
Enumeration Date
2005-06-16
Last Update Date
2014-06-16
Business Address
-- FAITH P WAGNER NP
2500 STATE RD
LA CROSSE, WI 54601-5098
Phone number: 608-775-5858
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Mailing Address
-- FAITH P WAGNER NP
1836 SOUTH AVE
LA CROSSE, WI 54601-5429
Phone number: 608-782-7300
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