Individual
ASHLEY E WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
1850 E PARK AVE, STE 302, STATE COLLEGE, PA 16803-6706
(814) 278-4680
(814) 235-1523
Mailing address
1850 E PARK AVE, STE 302, STATE COLLEGE, PA 16803-6706
(814) 278-4680
(814) 235-1523
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN579355
PA
363LF0000X
Family Nurse Practitioner
Primary
SP014206
PA
Other
Enumeration date
07/18/2013
Last updated
05/31/2022
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