Individual
DEBRA ANN WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN591717
Contact information
Practice address
1700 S LINCOLN AVE BLDG 5, LEBANON, PA 17042-7597
(717) 272-6621
Mailing address
1700 S LINCOLN AVE BLDG 5, LEBANON, PA 17042-7597
(717) 272-6621
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN591717
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RN591717
RN LICENSE
PA
Enumeration date
04/23/2018
Last updated
04/23/2018
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