Individual
COURTNEY KAY WAGNER-BIJAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN FNP-C
Contact information
Practice address
3480 COLLEGE ST, BEAUMONT, TX 77701-4612
(409) 813-1677
(409) 813-1699
Mailing address
3406 COLLEGE ST STE 200, BEAUMONT, TX 77701-4612
(409) 813-1677
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
752722
TX
363LF0000X
Family Nurse Practitioner
Primary
AP131287
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
364744801
—
TX
Enumeration date
07/01/2016
Last updated
11/11/2024
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