Individual
KACI BROOKE WAGLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
103 CARTER PARK DR, SENECA, SC 29678-1152
(864) 482-2360
(864) 482-2365
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-8603
Taxonomy
Speciality
Code
Description
License number
State
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
Primary
27507
SC
Other
Enumeration date
06/17/2022
Last updated
07/25/2023
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