Individual
MICHELLE WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
4949 LIBERTY LN STE 210, ALLENTOWN, PA 18106-9063
(610) 966-2676
Mailing address
4949 LIBERTY LN STE 210, ALLENTOWN, PA 18106-9063
(610) 966-2676
Taxonomy
Speciality
Code
Description
License number
State
163WA2000X
Administrator Registered Nurse
Primary
RN555235
PA
Other
Enumeration date
08/15/2018
Last updated
08/15/2018
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