DANIEL WAGONER

INDIANAPOLIS, IN
NPI1952070799
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy363LF0000X Nurse Practitioner, Family
(Licence: IN  28226050A)
Additional Taxonomies363L00000X Nurse Practitioner
(Licence: IN  71011659A)
Enumeration Date2021-09-07
Last Update Date2025-10-02
Business Address
DANIEL WAGONER
8902 N MERIDIAN ST STE 101
INDIANAPOLIS, IN 46260-5306
Phone number: 317-848-8048
Mailing Address
DANIEL WAGONER
PO BOX 637764
CINCINNATI, OH 45263-7764
Phone number: 317-880-3939