Individual
AMBER WAGLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1818 CAREW ST STE 120, FORT WAYNE, IN 46805-4764
(260) 425-6200
(260) 425-6205
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28236162A
IN
363L00000X
Nurse Practitioner
Primary
71012754A
IN
Other
Enumeration date
06/28/2022
Last updated
10/17/2022
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