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1861266017
KIMBERLY DAWN WAGNER
MEMPHIS, TN
NPI
1861266017
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: TN 34905)
Enumeration Date
2023-11-08
Last Update Date
2024-06-03
Business Address
KIMBERLY DAWN WAGNER FNP-BC
6000 POPLAR AVE STE 250
MEMPHIS, TN 38119-3974
Phone number: 574-546-1900
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Mailing Address
KIMBERLY DAWN WAGNER FNP-BC
1087 HEATHWOOD WEST DR
COOKEVILLE, TN 38506-6633
Phone number: 193-126-5429
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