Individual provider · Type 1 NPI
Keith William Wagoner, BSN, RN-BC
Gerontology Registered Nurse · Kemp, TX
NPI number
1407673593
Active
Practice location
110 N State Highway 274
Kemp, TX 75143-4617
Mailing address
105 Arapaho Trl
Mabank, TX 75156-9176
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Gerontology Registered Nurse Primary | 163WG0600X | 919371 (TX) |
Gerontology Registered Nurse: Definition to come...
About NPI 1407673593
Keith William Wagoner, BSN, RN-BC's National Provider Identifier is 1407673593, issued on Sep 20, 2024. The primary taxonomy on file is Gerontology Registered Nurse (163WG0600X), and the practice location is in Kemp, TX. The record was last updated on Sep 20, 2024.