Individual
MISS AMY JEANNETTE WAGGONER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1 CVS DR, MAIL CODE 3005, WOONSOCKET, RI 02895-6146
(512) 791-6564
Mailing address
7206 EGANHILL DR, AUSTIN, TX 78745-5114
(512) 791-6564
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
617781
TX
Other
Enumeration date
03/14/2006
Last updated
03/20/2017
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