Individual
BRYAN WAGAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN, BSN
Contact information
Practice address
1025 BEVERLY GARDEN DR, METAIRIE, LA 70002-5003
(504) 439-6935
Mailing address
2008 TAFT PARK, METAIRIE, LA 70001-2661
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
225887
LA
Other
Enumeration date
04/02/2020
Last updated
07/10/2023
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