Individual
MS. FIDELA WAGGONER
Active
Individual
MS. FIDELA WAGGONER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N.
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
Primary
352490
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
352490
REGISTERED NURSE
CA
01
—
RVN003000
PROVIDER NUMBER
CA
Enumeration date
05/03/2007
Last updated
07/08/2007
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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