Individual
GAIL R WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
4101 S 4TH ST, LEAVENWORTH, KS 66048-5014
(913) 682-2000
Mailing address
1010 N 4TH ST, LANSING, KS 66043-1145
(913) 682-2000
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
44658
KS
Other
Enumeration date
06/23/2006
Last updated
07/08/2007
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