Individual
TERESA ANN WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1036 HIGHWAY 64 E, ALMA, AR 72921-6807
(479) 632-3813
(479) 632-8986
Mailing address
PO BOX 2389, ALMA, AR 72921-2389
(479) 632-3813
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R100625
AR
Other
Enumeration date
07/24/2024
Last updated
07/24/2024
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