Most Relevant Information
Provider Data
| NPI Number: | 1003377516 |
| Provider Name: | JEANNENE DONNA WAGNER LPN |
| Entity Type: | Individual |
| Taxonomy Code: | 164W00000X |
| Specialty: | Licensed Practical Nurse |
| License Number: | 324664 |
Most Important Dates
| Enumeration Date: | 03/27/2019 |
| Last Updated: | 03/27/2019 |
Provider Practice Location
9 ROCHESTER ST
SCOTTSVILLE
NY
145461331
Practice Location Phone/Fax
| Phone: | 5853158198 |
| Fax: |
Provider Mailing Location
9 ROCHESTER ST
SCOTTSVILLE
NY
145461331
Provider Mailing Phone/Fax
| Phone: | 5853158198 |
| Fax: |