Individual
SARA WAGGONER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2725 LINCOLN ST E, CANTON, OH 44707-2769
(330) 454-2000
Mailing address
2725 LINCOLN ST E, CANTON, OH 44707-2769
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN.454092
OH
363LA2200X
Adult Health Nurse Practitioner
Primary
APRN.CNP.0037701
OH
Other
Enumeration date
09/10/2024
Last updated
10/11/2024
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