JACOB BRADLEY WAGNER DNAP
Individual Provider (NPI-1)
Active
Registered Nurse, Critical Care Medicine
Provider Information
- NPI Number
1376251009- Provider Type
- Individual Provider (NPI-1)
- Credentials
- DNAP
- Status
- Active
Contact & Location
- Address
- 315 HOSPITAL DR, MADISON, TN, 371155030
- Phone
- (615) 732-7662
Specialties & Taxonomies
Registered Nurse, Critical Care Medicine
Primary License: TN #267408
Nurse Anesthetist, Certified Registered
License: KY #4051451