Individual
MS. KRISTEN LARAMIE WAGONER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
500 SALEM ST, WILMINGTON, MA 01887-1200
(978) 988-6000
(978) 657-4169
Mailing address
PO BOX 760, WINCHESTER, MA 01890-4260
(781) 756-7273
(781) 721-0725
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
2270616
MA
Other
Enumeration date
08/29/2012
Last updated
06/10/2016
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