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Ebony Wagner
Licensed Practical Nurse in Florissant, Missouri
NPI 1417402397

Ebony Wagner is a Licensed Practical Nurse based in Florissant, MO. Ebony Wagner practices in Florissant, MO. The NPI Number for Ebony Wagner is 1417402397 and holds a License No. 2013023536 (Missouri).

The current practice location address for Ebony Wagner is 2325 Patterson Rd, Florissant, MO and can be reached out via phone at 314-620-5553 and via fax at 314-584-5002.

Location: 2325 Patterson Rd, Florissant, MO, 63031-2205
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1417402397
Provider Name
Ebony Wagner
Credential
Provider Entity Type
Individual
Gender
Female
Address
2325 Patterson Rd, Florissant, MO, 63031-2205
Phone Number
314-620-5553
Fax Number
314-584-5002
Provider Enumeration Date
08/19/2016
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
2325 Patterson Rd
City
Florissant
State
Missouri
Zip
63031-2205
Phone Number
314-620-5553
Fax Number
314-584-5002
person
Provider Business Mailing Address Details
Address
2325 Patterson Rd
City
Florissant
State
Missouri
Zip
63031-2205
Phone Number
314-620-5553
Fax Number
314-584-5002
person
Provider's Taxonomy Details 1
Type
Nursing Service Providers
Classification
Licensed Practical Nurse
Speciality
-
Taxonomy
164W00000X
License No.
2013023536 (Missouri)
Definition
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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