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Individual

LISA MARIE WANGBERG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
FNP/DNP

Contact information

Practice address
1505 FRANKLIN RD SW, ROANOKE, VA 24016-5206
(540) 343-7331
(540) 343-7349
Mailing address
303 VALLEYWOOD DR, FOREST, VA 24551-2809
(907) 775-2407

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
0024185593
VA

Other

Enumeration date
11/14/2022
Last updated
11/14/2022
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