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Individual
KIMBERLY H WAGNER
Active
Individual
KIMBERLY H WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.N., F.N.P
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP116554
TX
363LF0000X
Family Nurse Practitioner
RN 603948
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
220100601
—
TX
01
—
603948
RN FNP LICENSE
TX
Enumeration date
02/21/2008
Last updated
03/06/2025
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