Individual
JESSICA WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1035 SUNRISE WAY, DACONO, CO 80514-9359
(970) 988-2950
Mailing address
1035 SUNRISE WAY, DACONO, CO 80514-9359
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
1641680
CO
Other
Enumeration date
10/07/2024
Last updated
10/07/2024
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