Individual provider · Type 1 NPI

Courtney Lee Wagner, LPN

Licensed Practical Nurse · Crestview, FL

NPI number 1295914331 Active

Practice location

6261 Old Bethel Rd
Crestview, FL 32536-5507

Fax (850) 683-7523

Mailing address

221 Hospital Dr NE
Fort Walton Beach, FL 32548-5066

Specialties and licenses

TaxonomyCodeLicense
Licensed Practical Nurse Primary 164W00000XPN5178468 (FL)

Licensed Practical Nurse: An individual 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.

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About NPI 1295914331

Courtney Lee Wagner, LPN's National Provider Identifier is 1295914331, issued on Oct 25, 2007. The primary taxonomy on file is Licensed Practical Nurse (164W00000X), and the practice location is in Crestview, FL. The record was last updated on Oct 25, 2007.