Individual
RUTH HATTIE WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
3715 DAUPHIN ST STE 4400, MOBILE, AL 36608-1727
(251) 607-9797
(251) 607-7696
Mailing address
6701 AIRPORT BLVD STE D330, MOBILE, AL 36608-6758
(251) 607-9797
(251) 607-7696
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1-087424
AL
Other
Enumeration date
07/30/2019
Last updated
07/30/2019
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