Individual
SAMANTHA M WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RNFA
Contact information
Practice address
191 N MAIN ST, WELLSVILLE, NY 14895-1150
(585) 593-1100
Mailing address
191 N MAIN ST, WELLSVILLE, NY 14895-1150
(585) 593-1100
Taxonomy
Speciality
Code
Description
License number
State
163WR0006X
Registered Nurse First Assistant
Primary
552294
NY
Other
Enumeration date
08/18/2016
Last updated
08/18/2016
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