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General NPI Number Information
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NPI Number | 1760316087
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Entity Type | Individual
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Provider Name | ANNA WAGNER RN
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Gender | Female
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Dates
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Enumeration Date | 06/11/2026
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Last Update Date | 06/11/2026
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Provider Practice Location Address
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Address Line | 209 N COURT ST
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City | CARLISLE
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State | AR
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Zip | 72024-9154
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Country | US
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Telephone | 501-703-0390
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Fax |
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Provider Business Mailing Address
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Address Line | 717 CENTER ST
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City | CARLISLE
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State | AR
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Zip | 72024-9335
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Country | US
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Telephone | 501-773-4528
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 224870
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License Number State | AR
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