Individual
MRS. LORENA WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
124 E GATE CITY BLVD, GREENSBORO, NC 27406-1457
(516) 342-0102
Mailing address
124 E GATE CITY BLVD, GREENSBORO, NC 27406-1457
(516) 342-0102
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
291498
NC
Other
Enumeration date
02/13/2023
Last updated
03/11/2023
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