Most Relevant Information
Provider Data
| NPI Number: | 1003252347 |
| Provider Name: | HIEDI LYNN AGNER LPN |
| Entity Type: | Individual |
| Taxonomy Code: | 164W00000X |
| Specialty: | Licensed Practical Nurse |
| License Number: | 314353-1 |
Most Important Dates
| Enumeration Date: | 05/14/2013 |
| Last Updated: | 05/14/2013 |
Provider Practice Location
4031 ONONDAGA BLVD
CAMILLUS
NY
130319709
Practice Location Phone/Fax
| Phone: | 3153147990 |
| Fax: |
Provider Mailing Location
4031 ONONDAGA BLVD
CAMILLUS
NY
130319709
Provider Mailing Phone/Fax
| Phone: | 3153147990 |
| Fax: |