Individual
MRS. BONNIE ALEXANDER WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C, RDN
Contact information
Practice address
101 MANNING DR, CHAPEL HILL, NC 27514-4226
(919) 966-0134
(919) 966-6025
Mailing address
15 ABBEY RD, CHAPEL HILL, NC 27516-8088
(843) 252-8420
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
DX3884
MD
363A00000X
Physician Assistant
Primary
001009493
NC
Other
Enumeration date
12/07/2015
Last updated
10/08/2024
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