Individual
EVAN WAGNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1802 6TH AVE S, BIRMINGHAM, AL 35233-1932
(205) 934-3411
Mailing address
1802 6TH AVE S, BIRMINGHAM, AL 35233-1932
(205) 934-3411
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
1-171257
AL
Other
Enumeration date
11/26/2025
Last updated
11/26/2025
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