Individual
BROOKE ALLAN WAGONER PAYTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN NNP
Contact information
Practice address
5201 HARRY HINES BLVD, DALLAS, TX 75235-7708
(214) 590-8000
Mailing address
1803 WEANNE DR, RICHARDSON, TX 75082-3105
(214) 343-2440
Taxonomy
Speciality
Code
Description
License number
State
363LN0000X
Neonatal Nurse Practitioner
Primary
AP133692
TX
Other
Enumeration date
07/12/2017
Last updated
08/11/2022
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