Individual
KEREN WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP, CRNA
Contact information
Practice address
2105 E SOUTH BLVD, MONTGOMERY, AL 36116-2409
(334) 288-2100
Mailing address
113 S PERRY ST STE 206, LAWRENCEVILLE, GA 30046-4811
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
1-200299
AL
367500000X
Certified Registered Nurse Anesthetist
APRN.CRNA.019970
OH
367500000X
Certified Registered Nurse Anesthetist
RN597039
PA
Other
Enumeration date
04/03/2019
Last updated
02/25/2025
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