Individual
BARBARA JOYCE WAGNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
2001 CRYSTAL SPRING AVE SW STE 302, ROANOKE, VA 24014-2465
(540) 981-7653
Mailing address
213 S JEFFERSON ST STE 1006, ROANOKE, VA 24011-1713
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
0024177032
VA
363LF0000X
Family Nurse Practitioner
Primary
0024177032
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0024177032
NURSE PRACTITIONER LICENSE
VA
Enumeration date
12/08/2018
Last updated
08/11/2022
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