Individual
HOLLY KAY WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2986 KATE BOND RD, BARTLETT, TN 38133-4003
(901) 491-2692
Mailing address
2986 KATE BOND RD, BARTLETT, TN 38133
(901) 491-2692
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN0000163346
TN
Other
Enumeration date
06/10/2013
Last updated
06/10/2013
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