Shannon Michelle Wagner, REGISTERED NURSE

NPI #1255956512 in Eagle, Colorado

Provider Information

NPI Number: 1255956512
Entity Type: Individual
Name: Shannon Michelle Wagner, REGISTERED NURSE
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Registered Nurse
Credential: REGISTERED NURSE
Enumeration Date: Jun 12, 2020
Last Updated: Jun 12, 2020

Practice Location

Address: 551 BROADWAY
City: Eagle
State: Colorado
ZIP Code: 81631
Phone: (970) 328-8840

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Registered Nurse	163W00000X	Primary

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