Individual
KATELYN WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGPCNP
Contact information
Practice address
6740 SHAWNEE RD, NORTH TONAWANDA, NY 14120-9504
(716) 903-7229
Mailing address
6740 SHAWNEE RD, NORTH TONAWANDA, NY 14120-9504
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
312752
NY
Other
Enumeration date
03/16/2026
Last updated
03/16/2026
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