Nicole L Wagner, PHARMD

NPI #1164759882 in Watauga, Texas

Provider Information

NPI Number: 1164759882
Entity Type: Individual
Name: Nicole L Wagner, PHARMD
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Pharmacist
Credential: PHARMD
Enumeration Date: Nov 17, 2009
Last Updated: Nov 17, 2009

Practice Location

Address: 6601 WATAUGA RD STE 126
City: Watauga
State: Texas
ZIP Code: 76148-3331
Phone: (817) 702-6634

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pharmacist	183500000X	Primary

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