Waggoner, Tara Lisa
Waggoner, Tara Lisa is an individual health care provider with primary practice located at 333 Stadium Blvd. Suite B, Jonesboro AR 72401. 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, Tara Lisa can be contacted via phone (870) 972-2054.Contact Information
Primary practice address
333 Stadium Blvd. Suite B
Jonesboro AR 72401
Phone: (870) 972-2054
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | A01852 | Arkansas |
Profile Details
NPI number | 1568515930 |
---|---|
LBN Legal business name | Waggoner, Tara Lisa |
Credentials | FNP, APN-BC |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Jan 19th, 2007 |
Last updated | Jul 8th, 2007 - about 17 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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