Individual
STEPHANIE LYNN WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
733 N BEERS ST, HOLMDEL, NJ 07733-1528
(732) 739-2100
Mailing address
156 MAGNOLIA LN, MIDDLETOWN, NJ 07748-1859
(732) 433-8651
Taxonomy
Speciality
Code
Description
License number
State
163WS0121X
Plastic Surgery Registered Nurse
Primary
26NR10508500
NJ
Other
Enumeration date
05/02/2021
Last updated
05/02/2021
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