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Individual
DENISE LEA WAGNER
Active
Individual
DENISE LEA WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
29673
SC
367A00000X
Advanced Practice Midwife
Primary
29673
SC
367A00000X
Advanced Practice Midwife
B180151
IA
Other
Enumeration date
09/13/2024
Last updated
04/28/2026
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