Individual
RYAN AUSTIN WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
2080 W ARLINGTON BLVD STE B, GREENVILLE, NC 27834-3770
(252) 752-2140
(252) 689-6502
Mailing address
2080 W ARLINGTON BLVD STE B, GREENVILLE, NC 27834-3770
(252) 752-2140
(252) 689-6502
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
293017
NC
367500000X
Certified Registered Nurse Anesthetist
Primary
6648
NC
Other
Enumeration date
08/09/2020
Last updated
06/02/2021
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