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Individual

MADELINE MICHELLE WAGNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
3333 BURNET AVE, CINCINNATI, OH 45229-3026
(859) 445-6938
Mailing address
102 BARTLETT AVE, ERLANGER, KY 41018-1604
(859) 445-6938

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
026635
OH

Other

Enumeration date
07/05/2020
Last updated
07/05/2020
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