Individual
KELLY ANN WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C, APRN
Contact information
Practice address
1395 EISENHOWER DR, SAVANNAH, GA 31406-3901
(912) 356-2441
Mailing address
18 S CROMWELL RD, SAVANNAH, GA 31410-4421
(410) 652-7666
(912) 216-3436
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN266801
GA
Other
Enumeration date
11/03/2015
Last updated
06/12/2023
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