Individual
MRS. KIMBERLY LUE WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5825 DELMONICO DR STE 102, COLORADO SPRINGS, CO 80919-2243
(719) 715-4882
(303) 381-1566
Mailing address
5825 DELMONICO DR STE 102, COLORADO SPRINGS, CO 80919-2243
(303) 381-0929
(303) 381-1566
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
DR.0053519
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03254356
—
CO
Enumeration date
04/23/2010
Last updated
06/16/2026
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