EBONY WAGNER NPI 1417402397

NPI Information

Ebony Wagner is a licensed practical nurse in Florissant, MO. The provider is a licensed practical nurse with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states. Ebony Wagner NPI is 1417402397. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

2325 PATTERSON RD
FLORISSANT, MO
ZIP 63031-205
Phone: (314) 620-5553
Fax: (314) 584-5002

The enumeration date for this NPI number is 8/19/2016 and was last updated on 8/19/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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