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Individual

SARAH WAGONER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
9300 E 29TH ST N STE 204, WICHITA, KS 67226-2183
(316) 500-6000
Mailing address
1421 E ROUGH CREEK PL, DERBY, KS 67037-8568
(620) 210-0039

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5379450
KS

Other

Enumeration date
06/10/2020
Last updated
06/10/2020
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