Individual provider · Type 1 NPI

Brian George Wagoner, RN, FNP BC

Family Nurse Practitioner · Springfield, MO

NPI number 1306083480 Active

Practice location

1235 E Cherokee St
Springfield, MO 65804-2203

Call (417) 820-9729 Map

Fax (417) 820-6471

Mailing address

PO Box 2580
Springfield, MO 65801-2580

Specialties and licenses

TaxonomyCodeLicense
Family Nurse Practitioner Primary 363LF0000X155580 (MO)

Family Nurse Practitioner: Definition to come...

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About NPI 1306083480

Brian George Wagoner, RN, FNP BC's National Provider Identifier is 1306083480, issued on Jan 12, 2009. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Springfield, MO. The record was last updated on Jun 10, 2009.