Individual
KAREN MAE WAGANER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
2113 ADAMS GRV STE 101, COLUMBIA, SC 29203-6957
(803) 256-0531
(803) 765-9052
Mailing address
2113 ADAMS GRV STE 101, COLUMBIA, SC 29203-6957
(803) 256-0531
(803) 765-9052
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
P3932
SC
Other
Enumeration date
07/11/2006
Last updated
01/27/2010
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