Individual
APRIL DIANE WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1617 S HAWTHORNE RD, WINSTON SALEM, NC 27103-4127
(336) 842-6980
Mailing address
1617 S HAWTHORNE RD, WINSTON SALEM, NC 27103-4127
(336) 842-6980
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
83324
NC
Other
Enumeration date
11/11/2022
Last updated
11/11/2022
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