Michelle Diane Waggoner, lpn
Licensed Practical Nurse in Dayton, OH. Individual provider (NPI-1).
NPI number1124585641
StatusActive
Last updated in NPPESDec 20, 2019
Details
- NPI
- 1124585641
- Entity type
- Individual (NPI-1)
- Name
- Michelle Diane Waggoner
- Credential
- lpn
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Feb 21, 2019
- Certification date
- Dec 20, 2019
- Last updated
- Dec 20, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 164W00000X | Licensed Practical Nurse | LPN.130695.MEDS-IV | OH | Yes |
Practice location
8120 Garnet DrDayton, OH 45458-2141
Phone 513-834-7063 · Fax 513-873-1567
Mailing address
446 Morgan StCincinnati, OH 45206-2348
Phone 513-834-7063 · Fax 513-873-1567
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All 647 Licensed Practical Nurse providers in Dayton · All 15,314 providers in Dayton
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