Individual
SHERON A. WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP, NNP-BC
Contact information
Practice address
1500 S MAIN ST, FORT WORTH, TX 76104-4917
(817) 702-1166
(817) 702-1405
Mailing address
PO BOX 660599, DALLAS, TX 75266-0599
(214) 590-8487
Taxonomy
Speciality
Code
Description
License number
State
363LN0000X
Neonatal Nurse Practitioner
Primary
795013
TX
363LN0000X
Neonatal Nurse Practitioner
AP119908
TX
Other
Enumeration date
01/26/2011
Last updated
12/09/2020
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