Individual
MRS. LADONNA WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
8569 SUDLEY RD STE B, MANASSAS, VA 20110-3866
(703) 257-7749
(855) 254-4529
Mailing address
8569 SUDLEY RD STE B, MANASSAS, VA 20110-3866
(703) 257-7749
(855) 254-4529
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
0024172214
VA
Other
Enumeration date
12/03/2014
Last updated
10/06/2020
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