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1972036960
ANDREA WAGNER
FENTON, MI
NPI
1972036960
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: MI 4704226341)
Enumeration Date
2017-04-06
Last Update Date
2018-08-07
Business Address
-- ANDREA WAGNER NP
445 N FENWAY DR
FENTON, MI 48430-2666
Phone number: 810-750-6060
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Mailing Address
-- ANDREA WAGNER NP
445 N FENWAY DR
FENTON, MI 48430-2666
Phone number: 810-750-6060
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