Individual
MRS. ADRIENNE P WAGENBLAST
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
RN MS CDE
Contact information
Practice address
508 FULTON ST, DURHAM, NC 27705-3875
(919) 286-0411
Mailing address
913 THOREAU DR, RALEIGH, NC 27609-6038
(919) 286-0411
Taxonomy
Speciality
Code
Description
License number
State
163WD0400X
Diabetes Educator Registered Nurse
Primary
151774
NC
Other
Enumeration date
03/21/2006
Last updated
07/08/2007
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