MRS. CAROLYN WAGNER, NP
Nurse Practitioner - Family
Active
Individual
NPI: 1366419087
Specialties
| Specialty | Code | Primary | License |
|---|---|---|---|
| Nurse Practitioner - Family | 363LF0000X | Yes | 209-001389 (IL) |
Frequently Asked Questions
NPI 1366419087 is the National Provider Identifier for MRS. CAROLYN WAGNER, NP, a Nurse Practitioner - Family provider located in Decatur, IL. This NPI was enumerated on March 1, 2006.
MRS. CAROLYN WAGNER, NP practices at 1770 E LAKE SHORE DR, SUITE 207, Decatur, IL 62521.
Quick Facts
- NPI
- 1366419087
- Type
- Individual
- Enumerated
- Mar 1, 2006
- Last Updated
- Mar 10, 2011
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