Most Relevant Information
Provider Data
| NPI Number: | 1003180860 |
| Provider Name: | MONISA DEANNE WAGNER |
| Entity Type: | Individual |
| Taxonomy Code: | 363A00000X |
| Specialty: | Physician Assistant |
| License Number: | MA055437 |
Most Important Dates
| Enumeration Date: | 02/26/2012 |
| Last Updated: | 12/24/2020 |
Provider Practice Location
100 N ACADEMY AVE
DANVILLE
PA
178221339
Practice Location Phone/Fax
| Phone: | 5702717910 |
| Fax: | 5702716002 |
Provider Mailing Location
100 N ACADEMY AVE
CREDENTIALS DEPT
DANVILLE
PA
178224903
Provider Mailing Phone/Fax
| Phone: | 5702716144 |
| Fax: |