Individual
CYNTHIA WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
440 E MARSHALL ST STE 201, WEST CHESTER, PA 19380-5414
(610) 738-2500
Mailing address
440 E MARHSALL ST, STE 201, WEST CHESTER, PA 19380-5415
(610) 738-2500
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
SP011729
PA
363LG0600X
Gerontology Nurse Practitioner
Primary
SP011729
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
440771
MLHC MEDICARE GROUP AA #
PA
Enumeration date
03/23/2012
Last updated
07/21/2022
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