Individual
SHAENA VICTORIA WAGGONER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
140 ALLEN CT, NORTH AUGUSTA, SC 29860-9782
(803) 510-0007
Mailing address
140 ALLEN CT, NORTH AUGUSTA, SC 29860-9782
(803) 510-0007
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
293656
NC
363LF0000X
Family Nurse Practitioner
Primary
31005
SC
363LF0000X
Family Nurse Practitioner
GAA-NP002533
GA
Other
Enumeration date
07/01/2024
Last updated
10/16/2025
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