Individual provider · Type 1 NPI
Justin Edward Wagnon, NP-C
Adult Health Nurse Practitioner · Cordele, GA
NPI number
1295112183
Active
Practice location
415 E 4th Ave Ste C
Cordele, GA 31015-0614
Mailing address
105 E 4th Ave
Cordele, GA 31015-3262
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Gerontology Nurse Practitioner | 363LG0600X | RN217684 (GA) |
| Adult Health Nurse Practitioner Primary | 363LA2200X | RN217684 (GA) |
Adult Health Nurse Practitioner: Definition to come...
Another provider at this address
Other adult health nurse practitioner providers in Cordele
About NPI 1295112183
Justin Edward Wagnon, NP-C's National Provider Identifier is 1295112183, issued on Apr 30, 2015. The primary taxonomy on file is Adult Health Nurse Practitioner (363LA2200X), and the practice location is in Cordele, GA. The record was last updated on Jul 21, 2025.