Individual
JOAN ELLEN WAGGONER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BSPHARM
Contact information
Practice address
5455 ROBERTS ST, SHAWNEE, KS 66226-3937
(913) 667-1728
(913) 667-3368
Mailing address
510 CORONADO RD, BONNER SPRINGS, KS 66012
(913) 441-6935
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
1-10446
KS
Other
Enumeration date
10/15/2011
Last updated
10/15/2011
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