Individual
SHERRY WAGONER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
16752 N GREASEWOOD ST, SURPRISE, AZ 85378-3639
(623) 584-4999
Mailing address
16752 N GREASEWOOD ST, SURPRISE, AZ 85378-3639
(623) 584-4999
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
RN120134
AZ
Other
Enumeration date
05/02/2016
Last updated
05/02/2016
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