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Individual
MS. LORI A WAGNER
Active
Individual
MS. LORI A WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, APRN
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1078503
KY
363L00000X
Nurse Practitioner
3002772
KY
363LA2100X
Acute Care Nurse Practitioner
3002772
KY
363LA2200X
Adult Health Nurse Practitioner
Primary
3002772
KY
Other
Enumeration date
09/12/2005
Last updated
07/27/2023
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