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Individual
BROOKE WAGNER
Active
Individual
BROOKE WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
853791
NV
164W00000X
Licensed Practical Nurse
853791
NV
Other
Enumeration date
07/30/2024
Last updated
09/08/2026
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