Joanna Wagner, PA-C
Physician Assistant in Selinsgrove, PA. Individual provider (NPI-1).
NPI number1174102016
StatusActive
Last updated in NPPESMay 12, 2021
Details
- NPI
- 1174102016
- Entity type
- Individual (NPI-1)
- Name
- Joanna Wagner
- Credential
- PA-C
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Apr 7, 2021
- Certification date
- May 12, 2021
- Last updated
- May 12, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | MA062437 | PA | Yes |
| 207Q00000X | Family Medicine | MA062437 | PA |
Practice location
201 Roosevelt AveSelinsgrove, PA 17870-7969
Phone 570-374-0151
Mailing address
100 N Academy AveDanville, PA 17822-4903
Phone 570-271-6144 · Fax 570-271-6578
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All 17 Physician Assistant providers in Selinsgrove · All 304 providers in Selinsgrove
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