MR. CLARENCE WAGONER JR., CRNA

Nurse Anesthetist, Certified Registered

Active Individual
NPI: 1235126400

Practice Address

401 N. MAIN ST.
Kenansville, NC 28349

Phone: (910) 296-2608

Specialties

Specialty Code Primary License
Nurse Anesthetist, Certified Registered 367500000X Yes 059528 (NC)

Frequently Asked Questions

NPI 1235126400 is the National Provider Identifier for MR. CLARENCE WAGONER JR., CRNA, a Nurse Anesthetist, Certified Registered provider located in Kenansville, NC. This NPI was enumerated on October 4, 2005.
MR. CLARENCE WAGONER JR., CRNA practices at 401 N. MAIN ST., Kenansville, NC 28349.

Quick Facts

NPI
1235126400
Type
Individual
Enumerated
Oct 4, 2005
Last Updated
Aug 24, 2009

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