Waggoner, Kristina

Waggoner, Kristina is an individual health care provider with primary practice located at 101 E Plummer Blvd , Chatham IL 62629-8047. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Waggoner, Kristina can be contacted via phone (217) 483-3487.

Contact Information

Primary practice address
101 E Plummer Blvd Chatham IL 62629-8047
Phone: (217) 483-3487
Fax: (217) 483-8150
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 209012659 Illinois

Profile Details

NPI number 1861886715
LBN Legal business name Waggoner, Kristina
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 27th, 2015
Last updated Mar 27th, 2015 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1861886715 NPPES
Other 2014027437 ANCC CERTIFICATION

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