Ebony Wagner
NPI #1417402397 in Florissant, Missouri
Provider Information
- NPI Number
- 1417402397
- Entity Type
- Individual
- Name
- Ebony Wagner
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Licensed Practical Nurse
- Enumeration Date
- Aug 19, 2016
- Last Updated
- Aug 19, 2016
Practice Location
- Address
- 2325 PATTERSON RD
- City
- Florissant
- State
- Missouri
- ZIP Code
- 63031-2205
- Phone
- (314) 620-5553
Specialties & Taxonomy Codes
| Specialty |
|---|
| Licensed Practical Nurse |
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