Individual
ALICE WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
2900 PLANK RD STE 9, ALTOONA, PA 16601-9361
(814) 944-4722
Mailing address
319 WEAVER RD, DUNCANSVILLE, PA 16635-4302
Taxonomy
Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
RN512703L
PA
Other
Enumeration date
10/02/2017
Last updated
10/02/2017
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