Individual provider · Type 1 NPI

Beth A. Wagner, CRNP

Adult Health Nurse Practitioner · Philadelphia, PA

NPI number 1336104074 Active

Practice location

833 Chestnut Street, Suite 301
Philadelphia, PA 19107-4405

Fax (215) 923-9186

Specialties and licenses

TaxonomyCodeLicense
Adult Health Nurse Practitioner Primary 363LA2200XSP008597 (PA)

Adult Health Nurse Practitioner: Definition to come...

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About NPI 1336104074

Beth A. Wagner, CRNP's National Provider Identifier is 1336104074, issued on Apr 18, 2006. The primary taxonomy on file is Adult Health Nurse Practitioner (363LA2200X), and the practice location is in Philadelphia, PA. The record was last updated on Apr 6, 2011.