Individual
MRS. JEANNENE ROCHELLE WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
5320 N LOVINGTON HWY, HOBBS, NM 88240-9139
(575) 392-1973
(575) 392-2030
Mailing address
2215 NASHVILLE AVE, LUBBOCK, TX 79410-1105
(806) 725-5844
(806) 723-6532
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
R26431
NM
363LF0000X
Family Nurse Practitioner
Primary
03552
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1730635566
BCBS
NM
01
—
1K3729
MEDICARE
NM
Enumeration date
08/31/2016
Last updated
02/03/2021
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