Individual
KATHLEEN T WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
4545 E 9TH AVE, SUITE 502, DENVER, CO 80220-3910
(303) 320-2944
(303) 320-2947
Mailing address
4900 S. MONACO ST, SUITE 210, DENVER, CO 80237-3486
(303) 320-2944
(303) 320-2947
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
170630
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
63081253
—
CO
Enumeration date
02/08/2006
Last updated
01/11/2013
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