NPI 1043537152

Inice Marie Wagner

Practitioner Case Management Agency Madison, TN

Practice location

Address: 620 Gallatin Pike S, Madison, TN 37115-4013
Phone: (615) 460-4300
Fax: (615) 460-4308

Registered specialties

Case Management Agency Primary

Agencies Taxonomy 251B00000X

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Registry record

NPI: 1043537152
Entity type: Individual
Sex (as registered): Female
NPI issued: 28 Apr 2010
Record last updated: 28 Apr 2010

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.