Lana K Wagner MD

NPI 1003890112 - Family Medicine - 207Q00000X

NPI Details
NPI 1003890112
Gender Female
Enumeration Date 12/01/2005
Last Updated 10/29/2015
Entity Type Individual
Active Over 11 years ago
Practice Location
4100 HIGH RESORT BLVD SE
PMG RIO RANCHO HIGH RESORT 4100
RIO RANCHO NM, 87124-5901, US
Phone (505) 462-8520
Fax (505) 462-8510
Business Location
PO BOX 26666
PHS PROVIDER ENROLLMENT
ALBUQUERQUE NM, 87125-6666, US
Phone (505) 923-6770
Fax (505) 272-8060
Toxanomy
Taxonomy Code 207Q00000X
License State New Mexico
License Number 2000303
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According to our database, Lana K Wagner MD NPI is 1003890112, taxonomy code is 207Q00000X and license number is 2000303, license state is located at New Mexico. Lana K Wagner MD physically located at 4100 High Resort Blvd Se, Rio Rancho NM, 87124-5901. NPI Number Lana K Wagner MD has the Individual type.

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1003890112 NPI number is provided on an as is basis without warranty of any kind. 1003890112 is maintained by the National Plan & Provider Enumeration System. The contents of Lana K Wagner MD are for informational purposes only.