Individual
DR. NELL ANN WAGONER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3268 HOSPITAL DR SUITE B, JUNEAU, AK 99801-7808
(907) 586-1717
(907) 586-2677
Mailing address
3268 HOSPITAL DR SUITE B, JUNEAU, AK 99801-7808
(907) 586-1717
(907) 586-2677
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
2531
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
152092
INDIV MED
AK
05
—
MD2531
—
AK
Enumeration date
09/28/2006
Last updated
07/08/2007
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