Individual
MRS. KIMBERLY LUE WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2312 N NEVADA AVE, SUITE 100, COLORADO SPRINGS, CO 80907-5302
(719) 473-3272
(719) 473-1191
Mailing address
2312 N NEVADA AVE, SUITE 100, COLORADO SPRINGS, CO 80907-5302
(719) 473-3272
(719) 473-1191
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
12/29/2025
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