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1871756395
LANE GRAY WAGNON
CONWAY, AR
NPI
1871756395
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LA2200X Nurse Practitioner, Adult Health
(Licence: AR A02902)
Enumeration Date
2008-07-03
Last Update Date
2020-08-13
Business Address
Mrs. LANE GRAY WAGNON N.P.
525 WESTERN AVE SUITE 202
CONWAY, AR 72034-4967
Phone number: 501-513-5337
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Mailing Address
Mrs. LANE GRAY WAGNON N.P.
525 WESTERN AVE SUITE 202
CONWAY, AR 72034-4967
Phone number: 501-513-5337
Copy
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