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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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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