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Martha Laine Wagoner, FNP
Family Nurse Practitioner in North Charleston, South Carolina
NPI 1497129563

Martha Laine Wagoner is a Family Nurse Practitioner based in Charleston, SC and is specialized in Family. Martha Laine Wagoner practices in North Charleston, SC and has the professional credentials of FNP. The NPI Number for Martha Laine Wagoner is 1497129563 and holds a License No. 19800 (South Carolina).

The current practice location address for Martha Laine Wagoner is 2102 Otranto Blvd, North Charleston, SC and can be reached out via phone at 843-569-2225. You can also correspond with Martha Laine Wagoner through the mailing address at 1010 RIVER HAVEN CIR, CHARLESTON, SC - 29412-4121 (mailing address contact number: 731-610-6718).

Location: 2102 Otranto Blvd, North Charleston, SC, 29412-4121
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Provider Profile Details
NPI Number
1497129563
Provider Name
Martha Laine Wagoner
Credential
FNP
Provider Entity Type
Individual
Gender
Female
Address
2102 Otranto Blvd, North Charleston, SC, 29412-4121
Phone Number
843-569-2225
Fax Number
Provider Enumeration Date
11/30/2015
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
2102 Otranto Blvd
City
State
Zip
29406-9841
Phone Number
843-569-2225
Fax Number
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Provider Business Mailing Address Details
Address
1010 River Haven Cir
City
State
Zip
29412-4121
Phone Number
731-610-6718
Fax Number
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Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
License No.
19800 (South Carolina)
Definition
Definition to come...
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