Individual
MRS. ANNETTE MARIE WAGLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
4300 SW 13TH STREET, GAINESVILLE, FL 32608
(352) 562-2239
Mailing address
4300 SW 13TH ST, GAINESVILLE, FL 32608-4006
(352) 562-2239
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN5184662
FL
Other
Enumeration date
05/14/2015
Last updated
05/14/2015
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