STACY L WAGNER

WICHITA, KS
NPI1992054431
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy207RR0500X Internal Medicine, Rheumatology
(Licence: KS  15-01553)
Additional Taxonomies363A00000X Physician Assistant
(Licence:   15-01553)
Enumeration Date2012-08-30
Last Update Date2020-10-28
Business Address
STACY L WAGNER PA-C
1921 N WEBB RD
WICHITA, KS 67206-3405
Phone number: 316-612-4815
Mailing Address
STACY L WAGNER PA-C
1921 N WEBB RD
WICHITA, KS 67206-3405
Phone number: 316-612-4815