Individual
NANCY HELENE WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AGPCNP-BC, A-GNP-C
Contact information
Practice address
701 PALUXY RD, GRANBURY, TX 76048-2355
(817) 573-4585
Mailing address
701 PALUXY RD, GRANBURY, TX 76048-2355
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1123837
TX
Other
Enumeration date
07/28/2023
Last updated
02/07/2024
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