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Individual

MRS. KATHERINE LEIGH WAGNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
405 MAIN ST, HILLSBORO, MO 63050-4351
(636) 797-3737
(636) 481-2100
Mailing address
3023 N BALLAS RD STE 600D, SAINT LOUIS, MO 63131-2332
(314) 567-7018
(314) 567-7048

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1999137599
MO
363LF0000X
Family Nurse Practitioner
1999137599
MO

Other

Enumeration date
07/03/2006
Last updated
11/15/2021
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