Individual
MONICA WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8424 NAAB RD STE 1L, INDIANAPOLIS, IN 46260-1954
(317) 338-7780
Mailing address
1325 E 96TH ST, INDIANAPOLIS, IN 46240-1257
(317) 650-5653
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
28224168A
IN
Other
Enumeration date
10/29/2019
Last updated
06/19/2023
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