Individual
MRS. MARILOU WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
2025 MORSE AVE, SACRAMENTO, CA 95825-2115
(916) 973-7696
Mailing address
2025 MORSE AVE, SACRAMENTO, CA 95825-2115
(916) 973-7696
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
480
PA
Other
Enumeration date
11/01/2006
Last updated
07/11/2007
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