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NPI Profile for LISA C WAGONER in HIGHLANDS RANCH, CO.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Administrator |
163WA2000X |
| NPI # | 1720438963 |
|
| Status | Active | |
| Credentials | RN, COHN-S | |
| Entity | Individual | |
| Enumeration date | 06/19/2016 | |
| Last updated | 06/19/2016 - About 10 years ago | |
| Sole proprietor 1 | Yes | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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LISA C WAGONER
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