Individual
MARY LANIER HUNTLEY-WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
813 INDEPENDENCE BLVD, VIRGINIA BEACH, VA 23455-6004
(757) 333-7625
Mailing address
860 OMNI BLVD STE 101, NEWPORT NEWS, VA 23606-4430
(757) 232-8769
(757) 232-8875
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
0024168926
VA
Other
Enumeration date
08/13/2009
Last updated
12/02/2019
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