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Individual
MS. PEGGY LYNN WAGNER
Active
Individual
MS. PEGGY LYNN WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209.002671
IL
Other
Enumeration date
05/19/2008
Last updated
05/19/2008
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