Individual
CHRISTINE RANKIN WAGGONER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
126 SYCAMORE RDG, MADISON, MS 39110-7069
(601) 899-2874
Mailing address
126 SYCAMORE RDG, MADISON, MS 39110-7069
(601) 899-2874
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R852672
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09228771
—
MS
Enumeration date
12/08/2011
Last updated
03/02/2016
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