Individual
DR. JESSIE WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
3901 RAINBOW BLVD, MAILSTOP 4034, KANSAS CITY, KS 66160
(913) 588-1908
Mailing address
3901 RAINBOW BLVD, MAILSTOP 4034, KANSAS CITY, KS 66160
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
94-11789
KS
Other
Enumeration date
04/01/2024
Last updated
06/13/2024
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