Individual
SHONNA MARIE WAGAMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
23000 MOAKLEY ST STE 206, LEONARDTOWN, MD 20650-2917
(410) 571-2946
(301) 632-6187
Mailing address
2 PARK CENTER CT STE 200, OWINGS MILLS, MD 21117-4221
(410) 571-2946
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R212454
MD
Other
Enumeration date
07/28/2020
Last updated
09/09/2020
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