Individual
DENISE LEA WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
1264 RIBAUT RD STE 200, BEAUFORT, SC 29902-6127
(843) 524-2466
Mailing address
6300 MERLE HAY RD UNIT 213, JOHNSTON, IA 50131-1596
(515) 452-6218
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
29673
SC
367A00000X
Advanced Practice Midwife
Primary
29673
SC
367A00000X
Advanced Practice Midwife
B180151
IA
Other
Enumeration date
09/13/2024
Last updated
04/28/2026
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