Amy Jeannette Waggoner, FNP
Nurse Practitioner, Family in Woonsocket, RI. Individual provider (NPI-1).
NPI number1194794271
StatusActive
Last updated in NPPESMar 20, 2017
Details
- NPI
- 1194794271
- Entity type
- Individual (NPI-1)
- Name
- Miss Amy Jeannette Waggoner
- Credential
- FNP
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Mar 14, 2006
- Last updated
- Mar 20, 2017
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | 617781 | TX | Yes |
Practice location
1 Cvs DrMail Code 3005
Woonsocket, RI 02895-6146
Phone 512-791-6564
Mailing address
7206 Eganhill DrAustin, TX 78745-5114
Phone 512-791-6564
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