Wagnon, Gweneth

Wagnon, Gweneth is an individual health care provider with primary practice located at 300 2Nd Ave , Long Branch NJ 07740-6303. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Wagnon, Gweneth can be contacted via phone (732) 923-7790.

Contact Information

Primary practice address
300 2Nd Ave Long Branch NJ 07740-6303
Phone: (732) 923-7790
Fax: (732) 571-4787
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 26NN06687400 New Jersey

Profile Details

NPI number 1457497976
LBN Legal business name Wagnon, Gweneth
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 30th, 2007
Last updated Oct 14th, 2011 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1457497976 NPPES
New Jersey MEDICAID 8717001

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