Individual
CYNTHIA K. WAGGONER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
650 JOEL DR, FORT CAMPBELL, KY 42223-5318
(270) 956-0118
(270) 956-0118
Mailing address
330 PAGEANT LN, CLARKSVILLE, TN 37040-3854
(931) 648-5747
(931) 645-9019
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
92160
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
92160
RN
TN
Enumeration date
04/11/2007
Last updated
12/30/2008
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