Individual
MISS STEPHANIE LYNN WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BSN, RNC, IBCLC, RLC
Contact information
Practice address
181 E 119TH ST APT 8B, NEW YORK, NY 10035-4080
(571) 212-7673
Mailing address
181 E 119TH ST APT 8B, NEW YORK, NY 10035-4080
(571) 212-7673
Taxonomy
Speciality
Code
Description
License number
State
163WL0100X
Lactation Consultant (Registered Nurse)
Primary
L-66565
NY
Other
Enumeration date
04/12/2016
Last updated
04/12/2016
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