Individual
DEBRA LYNN WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
11700 N MERIDIAN ST # C240, CENTER FOR CHILDREN'S CANCER AND BLOOD DISEASES, CARMEL, IN 46032-4656
(317) 688-4673
(317) 688-3436
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
71000837A
IN
Other
Enumeration date
08/28/2008
Last updated
11/23/2020
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