Individual
MS. JENNIFER SUSAN WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
2590 ATLANTIC AVE, BOX 900, ROCHESTER, NY 14625-1543
(585) 249-5700
Mailing address
PO BOX 900, PENFIELD, NY 14526-0900
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
516172-1
NY
Other
Enumeration date
08/10/2015
Last updated
08/10/2015
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