Individual
CHRISTINE CAROL WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1500 EAST MEDICAL CENTER DR, 8TH FLOOR C.S. MOTT CHILDRENS HOSPITAL, ANN ARBOR, MI 48109-4254
(734) 763-4109
Mailing address
3621 S STATE ST, 700 KMS PLACE, ANN ARBOR, MI 48108
(734) 936-2047
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704094724
MI
Other
Enumeration date
03/28/2007
Last updated
08/08/2012
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