Individual
EARNESTINE WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
411 WILSON AVE W, THOMASVILLE, AL 36784-2015
(334) 609-1970
Mailing address
101 PARK PL, SELMA, AL 36701-6764
(334) 874-7428
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
1-118050
AL
Other
Enumeration date
01/23/2026
Last updated
01/23/2026
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