Individual
JANELLE WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
13301 N MERIDIAN AVE STE 300A, OKLAHOMA CITY, OK 73120-8357
(405) 849-5391
Mailing address
14501 PADDINGTON AVE, OKLAHOMA CITY, OK 73142-7803
(405) 834-5282
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R0058475
OK
Other
Enumeration date
08/28/2016
Last updated
09/29/2024
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