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Individual

DR. JENNIFER KATHLEEN WAGNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
2968 RODEO PARK DR W STE 150, SANTA FE, NM 87505-6383
(505) 913-5227
Mailing address
2968 RODEO PARK DR W STE 150, SANTA FE, NM 87505-6383
(505) 913-5227

Taxonomy

Speciality
Code
Description
License number
State
207XS0106X
Orthopaedic Hand Surgery Physician
Primary
MD2022-0186
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
59076356
NM
Enumeration date
07/07/2008
Last updated
05/12/2025
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