Individual
MRS. MAEGAN LYNN WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
2062 HIGHWAY 62 W, MOUNTAIN HOME, AR 72653-7656
(870) 425-5464
(870) 425-5465
Mailing address
P.O. BOX 763, MOUNTAIN HOME, AR 72654-0763
(870) 425-5464
(870) 425-5465
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
A003922
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
199560758
—
AR
Enumeration date
07/29/2013
Last updated
10/13/2023
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