Individual
HAILEY JORDAN WAGGONER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
800 ROSE ST, LEXINGTON, KY 40536-7001
(859) 323-6047
(859) 257-3873
Mailing address
800 ROSE ST, LEXINGTON, KY 40536-7001
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3011637
KY
Other
Enumeration date
11/01/2017
Last updated
07/20/2021
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