Waggoner, Kristina L
Waggoner, Kristina L is an individual health care provider with primary practice located at 805 North Dickinson Drive , Rusk TX 75785. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, which is considered as her primary health care specialty. Waggoner, Kristina L can be contacted via phone (903) 683-7201.Contact Information
Primary practice address
805 North Dickinson Drive
Rusk TX 75785
Phone: (903) 683-7201
Fax: (903) 683-7199
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health | 363LP0808X | 763777 | Texas |
Profile Details
| NPI number | 1770823759 |
|---|---|
| LBN Legal business name | Waggoner, Kristina L |
| Credentials | PMHNP-BC |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 27th, 2013 |
| Last updated | May 19th, 2014 - about 10 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1770823759 | NPPES |
| Texas | Other | 763777 | STATE LICENSE |
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