Individual
MS. JENNIFER KAY WAGSTAFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-5222
Mailing address
4150 DUDLEYS GRANT DR APT F, WINTERVILLE, NC 28590-8344
(704) 607-9558
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/20/2009
Last updated
04/20/2009
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