Individual
LAURIEANN WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
2467 OLD CORNELIA HWY, GAINESVILLE, GA 30507-7853
(678) 960-2700
Mailing address
3820 PINEWOOD CT, CUMMING, GA 30041-2018
(856) 304-4267
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
RN217362
GA
Other
Enumeration date
03/16/2023
Last updated
03/16/2023
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