Most Relevant Information
Provider Data
| NPI Number: | 1003013525 |
| Provider Name: | NICOLE MARILYN WAGSCHAL MSN APRN |
| Entity Type: | Individual |
| Taxonomy Code: | 363LF0000X |
| Specialty: | Nurse Practitioner |
| License Number: | 005423 |
Most Important Dates
| Enumeration Date: | 06/28/2007 |
| Last Updated: | 10/29/2013 |
Provider Practice Location
3514 MAIN ST
CVS- MINUTE CLINIC
COVENTRY
CT
062381551
Practice Location Phone/Fax
| Phone: | 8663892727 |
| Fax: |
Provider Mailing Location
150 BALAZS RD
WILLINGTON
CT
062792401
Provider Mailing Phone/Fax
| Phone: | 8663892727 |
| Fax: |