# REBECCA S WAGGONER

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1144612508
- **Gender:** F
- **Credential:** NP

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 163W00000X | Registered Nurse | RN60123376 | WA | — |
| 363L00000X | Nurse Practitioner | 1004878 | TX | Yes |
| 363LA2100X | Acute Care Nurse Practitioner | AP60542393 | WA | — |

## Other

- **Enumeration date:** 02/23/2015
- **Last updated:** 06/17/2025