Individual
MEGAN ASHLEY WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
10012 KENNERLY RD STE 406, SAINT LOUIS, MO 63128-2197
(314) 525-1224
Mailing address
10012 KENNERLY RD STE 406, SAINT LOUIS, MO 63128-2197
(314) 525-1224
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2020032292
MO
Other
Enumeration date
10/26/2020
Last updated
10/26/2020
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