Individual
MS. LAURA L. WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, BC, APNP
Contact information
Practice address
2810 CROSSROADS DR, MADISON, WI 53718-7942
(608) 819-0033
(608) 819-0048
Mailing address
2810 CROSSROADS DR, MADISON, WI 53718-7942
(608) 819-0033
(608) 819-0048
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
1352-033
WI
Other
Enumeration date
05/09/2007
Last updated
12/16/2014
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