Individual
KRISTY MICHELLE WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1940 ALCOA HWY, SUITE 120, KNOXVILLE, TN 37920-2244
(865) 305-8040
(865) 305-8041
Mailing address
1940 ALCOA HWY, SUITE 120, KNOXVILLE, TN 37920-2244
(865) 305-8040
(865) 305-8041
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA938
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1510179
—
TN
Enumeration date
12/21/2006
Last updated
06/04/2015
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