Individual
MS. CRISTINA SUZANNE WAGONER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
REGISTERED NURSE
Contact information
Practice address
1 MED CENTER DR, CLARKSBURG, WV 26301-4155
(304) 623-3461
Mailing address
26 GABLES PL, BRIDGEPORT, WV 26330-9246
(304) 844-2330
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
60186
WV
163WM0705X
Medical-Surgical Registered Nurse
Primary
60186
WV
Other
Enumeration date
08/18/2014
Last updated
08/18/2014
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