Individual provider · Type 1 NPI

Shannon Mayhew Waggoner, FNP-C

Family Nurse Practitioner · Statesville, NC

NPI number 1629653670 Active

Practice location

700 Sullivan Rd
Statesville, NC 28677-3440

Call (704) 924-9111 Map

Fax (704) 883-0452

Mailing address

PO Box 1845
Statesville, NC 28687-1845

Specialties and licenses

Taxonomy	Code	License
Family Nurse Practitioner Primary	363LF0000X	5014171 (NC)

Family Nurse Practitioner: Definition to come...

11 other providers at this address

Adanma Mbadinuju Okwara, MDFamily Medicine Physician Statesville, NC NPI 1447295159
Burgo Doyle Gill Iii, PAPhysician Assistant Statesville, NC NPI 1881661205
Carol Lynn Latorre, NPAdult Health Nurse Practitioner Statesville, NC NPI 1811291636
Cynthia Loree Mitchell, P.A.-CPhysician Assistant Statesville, NC NPI 1073677720
Jason Thomas Noble, PA-CPhysician Assistant Statesville, NC NPI 1780130518
Kelly A. Bennett, PAPhysician Assistant Statesville, NC NPI 1982634762
Kelly Ann Boone, FNPFamily Nurse Practitioner Statesville, NC NPI 1558324152
Kelly Michelle Moss, NPFamily Nurse Practitioner Statesville, NC NPI 1841640455
Paul Anthony Leonard, PAPhysician Assistant Statesville, NC NPI 1306035373
Robert Roy Kimball, MDFamily Medicine Physician Statesville, NC NPI 1518959063
Wesley James Lockman, FNP-BC, RNFamily Nurse Practitioner Statesville, NC NPI 1194379123

Other family nurse practitioner providers in Statesville

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About NPI 1629653670

Shannon Mayhew Waggoner, FNP-C's National Provider Identifier is 1629653670, issued on Mar 11, 2021. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Statesville, NC. The record was last updated on Oct 15, 2026.