Individual
DEBORAH LEANORA WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE
Contact information
Practice address
10734 1/2 TUJUNGA CANYON BLVD, TUJUNGA, CA 91042-1317
(310) 383-2429
Mailing address
10734 1/2 TUJUNGA CANYON BLVD, TUJUNGA, CA 91042-1317
(310) 383-2429
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
150758
CA
Other
Enumeration date
03/14/2022
Last updated
03/14/2022
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