Individual
JESSICA WAGMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
500 WINDERLEY PL, SUITE 115, MAITLAND, FL 32751-7247
(407) 875-0555
(407) 875-0244
Mailing address
500 WINDERLEY PL, SUITE 115, MAITLAND, FL 32751-7247
(407) 875-0555
(407) 875-0244
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN9278160
FL
Other
Enumeration date
04/13/2016
Last updated
04/13/2016
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