| NPI | 1952765810 |
|---|---|
| Former Name | ANNA LEE WAGNER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN180536) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL ARNP9415945) |
| Enumeration Date | 2016-04-07 |
| Last Update Date | 2024-10-17 |