Individual
MEGAN NICOLE WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2200 RANDALLIA DR, FORT WAYNE, IN 46805-4638
(260) 266-4480
Mailing address
504 CEDAR GLEN DR APT 4, FORT WAYNE, IN 46825-6214
(262) 339-6430
Taxonomy
Speciality
Code
Description
License number
State
1835P2201X
Ambulatory Care Pharmacist
Primary
26029474A
IN
Other
Enumeration date
11/13/2021
Last updated
11/13/2021
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