Individual
JENNIFER WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1947 N FOUNDERS CIR, WICHITA, KS 67206-3548
(316) 613-4640
(316) 613-4704
Mailing address
1947 N FOUNDERS CIR, WICHITA, KS 67206-3548
(316) 613-4640
(316) 613-4704
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
53-80310-042
KS
Other
Enumeration date
07/28/2021
Last updated
07/28/2021
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