Individual
ASHLEY WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
3302 15TH ST STE 100, TUSCALOOSA, AL 35401-2732
(205) 558-0877
(659) 219-7033
Mailing address
PO BOX 746063, ATLANTA, GA 30374-6063
(312) 733-9730
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
1-141241
AL
Other
Enumeration date
09/11/2015
Last updated
10/04/2024
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