Individual
LAURIE A WAGNER
Active
Individual
LAURIE A WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R32370
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q6459
—
NM
Enumeration date
03/08/2006
Last updated
07/02/2013
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