Organization
WAGGONER PEDIATRICS, PLC
Active
Other names
Waggoner Pediatrics of Central Iowa
Organization subpart
No
Provider details
NPI number
Authorized official
JULIE A WAGGONER ARNP (ARNP)
(515) 987-0051
Entity
Organization
Contact information
Practice address
2555 BERKSHIRE PKWY STE A, CLIVE, IA 50325-4646
(515) 987-0051
(515) 987-0054
Mailing address
2555 BERKSHIRE PKWY STE A, CLIVE, IA 50325-4646
(515) 987-0051
(515) 987-0054
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
28129
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1679544548
NPI
IA
Enumeration date
12/05/2016
Last updated
05/08/2017
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