Courtney Lee Wagner, LPN

NPI #1295914331 in Crestview, Florida

Provider Information

NPI Number
1295914331
Entity Type
Individual
Name
Courtney Lee Wagner, LPN
Gender
Not Specified
Sole Proprietor
No
Primary Specialty
Licensed Practical Nurse
Credential
LPN
Enumeration Date
Oct 25, 2007
Last Updated
Oct 25, 2007

Practice Location

Address
6261 OLD BETHEL RD
State
Florida
ZIP Code
32536-5507
Phone
(850) 683-7500

Specialties & Taxonomy Codes

Specialty
Licensed Practical Nurse

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