Nicole Wagon

NPI #1396198891 in Arapahoe, Wyoming

Provider Information

NPI Number: 1396198891
Entity Type: Individual
Name: Nicole Wagon
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Community Health Worker
Enumeration Date: Jul 20, 2016
Last Updated: Jul 20, 2016

Practice Location

Address: #24 GREAT PLAINS RD
City: Arapahoe
State: Wyoming
ZIP Code: 82510-0024
Phone: (307) 856-0470

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Community Health Worker	172V00000X	Primary

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