Individual
MRS. PATRICIA ANN WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
3980 SHERIDAN DR, AMHERST, NY 14226-1727
(716) 218-1030
(716) 218-1012
Mailing address
3980 SHERIDAN DR, AMHERST, NY 14226-1727
(716) 218-1030
(716) 218-1012
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
F306003-1
NY
Other
Enumeration date
09/10/2012
Last updated
09/10/2012
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