Individual provider · Type 1 NPI

Rebecca S. Waggoner, NP

Nurse Practitioner · Tyler, TX

NPI number 1144612508 Active

Practice location

703 S Fleishel Ave Ste 5000
Tyler, TX 75701-2015

Mailing address

PO Box 846098
Dallas, TX 75284-6098

Other practice locations

  • 550 17th Ave Ste 680, Seattle, WA 98122-5795 · (206) 861-8550

Specialties and licenses

TaxonomyCodeLicense
Registered Nurse 163W00000XRN60123376 (WA)
Acute Care Nurse Practitioner 363LA2100XAP60542393 (WA)
Nurse Practitioner Primary 363L00000X1004878 (TX)

Nurse Practitioner: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance wit…

8 other providers at this address

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About NPI 1144612508

Rebecca S. Waggoner, NP's National Provider Identifier is 1144612508, issued on Feb 23, 2015. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Tyler, TX. The record was last updated on Jun 17, 2025.